Der prognostische Wert eines PSMA-PET/CTs

In the content of an ageing society, it is crucial to focus on prostate cancer, optimizing both diagnostic and therapeutic methods. As the most common cancer and the second leading cause of cancer-related deaths in men, prostate cancer represents a significant global health and economic challenge. PSMA-PET/CT, which combines positron emission tomography with computer tomography, allows the highly specific detection of prostate cancer cells using the prostate-specific membrane antigen (PSMA). This method correlates closely with the degree of malignancy of the tumors. This study investigates the influence of various factors on progression-free survival in the recurrence diagnosis of prostate cancer, analyzing data of 180 patients. Variables such as patient age, tumor status, PSA-level, Gleason score and tumor spread at the time of the first 68Ga-PSMA-PET/CT scan were considered. Statistical analyses were conducted using survival analysis, incorporating both univariate and multivariate regression models. The results of the multivariate analysis indicate that the presence of bone metastases and a PSA value exceeding 3 ng/ml at the time of the first 68Ga-PSMA-PET/CT scan are significant and independent predictors of shorter progression-free survival. In addition, univariate analyses revealed that visceral metastases, the number of affected sites, the T-classification and the presence of metastases in general were also significant predictors of the survival time. A defined PSA threshold in recurrence diagnostics allows an enhanced assessment of the risk of progression and supports appropriate counseling and timely treatment initiation. The results validate and expand the assertation of the risk stratification for low and high risk of progression according to the publication by A. M. Werensteijn-Honingh et al. (2021), which also improves patient counseling regarding their prognosis and treatment options. Overall, the findings highlight the importance of PSMA-PET/CT in the recurrence diagnosis of prostate cancer and contribute to the optimization of disease management and the enhancement of patient quality of life.