Department of Nuclear Medicine, S. Andrea Hospital, La Spezia, Italy.
Department of Radiation Therapy, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Eur J Nucl Med Mol Imaging. 2018 Jun;45(6):962-969. doi: 10.1007/s00259-018-3944-0. Epub 2018 Feb 16.
Previous studies in prostate cancer (PCa) patients tried to correlate the onset of local recurrence (LR) with the development of distant metastases and formulated, based on theoretical and experimental data, hypotheses linking the two events. We aimed to address this issue with C-choline positron emission tomography/computed tomography (PET/CT).
This retrospective study included 491 PCa patients previously treated with radical prostatectomy who had undergone C-choline PET/CT owing to biochemical failure. Further inclusion criteria were availability of clinical and pathological variables for survival analysis. Statistical significance was taken at P < 0.05.
Seventy-two patients (14.7%) had evidence of LR at C-choline PET/CT. The frequency of LR increased from 13.8% in the interval 0-4 years after prostatectomy, to 23.9% in the 12-16-year interval (P = 0.080). On the contrary, the frequency of lymph node metastases (overall rate in the 0-16 years interval after prostatectomy: 26.3%) and of bone metastases (overall rate: 13.8%) decreased significantly over time. Kaplan-Meier curves showed no significant group difference in the rates of lymph node or bone metastases between patients with LR and patients without LR. LR significantly predicted PCa-specific survival at univariate analysis, but the statistical significance was lost at multivariate analysis.
We found no differences in the rates of lymph node and bone metastases between patients with and without LR. An inverse time-dependent trend was observed in the frequency of LR on one side and of lymph node and bone metastases on the other side. These findings were discussed in relation to previous theories linking LR to distant metastases and our study design.
先前在前列腺癌（PCa）患者中的研究试图将局部复发（LR）的发生与远处转移的发展相关联，并基于理论和实验数据提出了将这两个事件联系起来的假设。我们旨在使用 C-胆碱正电子发射断层扫描/计算机断层扫描（PET/CT）来解决这个问题。
这项回顾性研究包括 491 名先前因生化失败而行根治性前列腺切除术且接受 C-胆碱 PET/CT 检查的 PCa 患者。进一步的纳入标准是有生存分析的临床和病理变量。统计显著性取 P<0.05。
72 名患者（14.7%）在 C-胆碱 PET/CT 上有 LR 的证据。LR 的频率从前列腺切除术后 0-4 年的 13.8%增加到 12-16 年的 23.9%（P=0.080）。相反，淋巴结转移（前列腺切除术后 0-16 年的总体发生率：26.3%）和骨转移（总体发生率：13.8%）的频率随着时间的推移显著降低。Kaplan-Meier 曲线显示，LR 患者和无 LR 患者之间在淋巴结或骨转移的发生率方面没有显著的组间差异。LR 在单因素分析中显著预测 PCa 特异性生存，但在多因素分析中失去了统计学意义。
我们发现有 LR 和无 LR 的患者之间在淋巴结和骨转移的发生率方面没有差异。一方面是 LR 的频率呈反时间依赖性趋势，另一方面是淋巴结和骨转移的频率呈反时间依赖性趋势。这些发现与先前将 LR 与远处转移联系起来的理论以及我们的研究设计有关。
