Horn Thomas, Lischewski Flemming, Gschwend Jürgen E
Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Fakultät für Medizin, Technische Universität München, Ismaningerstr. 22, 81675, München, Deutschland.
Urologie. 2024 Mar;63(3):234-240. doi: 10.1007/s00120-024-02283-w. Epub 2024 Feb 8.
Prostate-specific membrane antigen (PSMA)-based positron emission tomography (PET) imaging allows early detection of metastases in patients with biochemical recurrence. Salvage lymphadenectomy became a widely used method of metastasis-directed treatment. Retrospective analyses show that a low prostate-specific antigen (PSA) value and presence of no more than two affected lymph nodes within the pelvis are factors associated with a good outcome. In all, 40-80% of patients achieve a complete biochemical response with a mean time without biochemical recurrence of 8 months and a prolonged treatment-free interval. About 10% of patients with a complete biochemical response will live without recurrence after 10 years. The utilization of PSMA-radioguided surgery increases the likelihood of intraoperative detection of suspicious affected lymph nodes. Complications can mostly be avoided by prudent patient selection and surgical expertise.
基于前列腺特异性膜抗原（PSMA）的正电子发射断层扫描（PET）成像可实现生化复发患者转移灶的早期检测。挽救性淋巴结清扫术成为广泛应用的转移灶靶向治疗方法。回顾性分析表明，低前列腺特异性抗原（PSA）值以及盆腔内受累淋巴结不超过两个是与良好预后相关的因素。总体而言，40%至80%的患者实现完全生化缓解，平均无生化复发时间为8个月，且无复发生存期延长。约10%实现完全生化缓解的患者在10年后将无复发存活。PSMA放射性引导手术的应用增加了术中检测可疑受累淋巴结的可能性。通过谨慎的患者选择和手术专业技能，大多数并发症是可以避免的。
