Abstract：
BACKGROUND: Various risk classification systems (RCSs) are used globally to stratify newly diagnosed patients with prostate cancer (PCa) into prognostic groups.
OBJECTIVE: To compare the predictive value of different prognostic subgroups (low-, intermediate-, and high-risk disease) within the RCSs for detecting metastatic disease on prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) for primary staging, and to assess whether further subdivision of subgroups would be beneficial.
METHODS: Patients with newly diagnosed PCa, in whom PSMA-PET/CT was performed between 2017 and 2022, were studied retrospectively. Patients were stratified into risk groups based on four RCSs: European Association of Urology, National Comprehensive Cancer Network (NCCN), Cambridge Prognostic Group (CPG), and Cancer of the Prostate Risk Assessment.
METHODS: The prevalence of metastatic disease on PSMA-PET/CT was compared among the subgroups within the four RCSs.
CONCLUSIONS: In total, 2630 men with newly diagnosed PCa were studied. Any metastatic disease was observed in 35% (931/2630) of patients. Among patients classified as having intermediate- and high-risk disease, the prevalence of metastases ranged from approximately 12% to 46%. Two RCSs further subdivided these groups. According to the NCCN, metastatic disease was observed in 5.8%, 13%, 22%, and 62% for favorable intermediate-, unfavorable intermediate-, high-, and very-high-risk PCa, respectively. Regarding the CPG, these values were 6.9%, 13%, 21%, and 60% for the corresponding risk groups.
CONCLUSIONS: This study underlines the importance of nuanced risk stratification, recommending the further subdivision of intermediate- and high-risk disease given the notable variation in the prevalence of metastatic disease. PSMA-PET/CT for primary staging should be reserved for patients with unfavorable intermediate- or higher-risk disease.
RESULTS: The use of various risk classification systems in patients with prostate cancer helps identify those at a higher risk of having metastatic disease on prostate-specific membrane antigen positron emission tomography/computed tomography for primary staging.
OBJECTIVE: To compare the predictive value of different prognostic subgroups (low-, intermediate-, and high-risk disease) within the RCSs for detecting metastatic disease on prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) for primary staging, and to assess whether further subdivision of subgroups would be beneficial.
METHODS: Patients with newly diagnosed PCa, in whom PSMA-PET/CT was performed between 2017 and 2022, were studied retrospectively. Patients were stratified into risk groups based on four RCSs: European Association of Urology, National Comprehensive Cancer Network (NCCN), Cambridge Prognostic Group (CPG), and Cancer of the Prostate Risk Assessment.
METHODS: The prevalence of metastatic disease on PSMA-PET/CT was compared among the subgroups within the four RCSs.
CONCLUSIONS: In total, 2630 men with newly diagnosed PCa were studied. Any metastatic disease was observed in 35% (931/2630) of patients. Among patients classified as having intermediate- and high-risk disease, the prevalence of metastases ranged from approximately 12% to 46%. Two RCSs further subdivided these groups. According to the NCCN, metastatic disease was observed in 5.8%, 13%, 22%, and 62% for favorable intermediate-, unfavorable intermediate-, high-, and very-high-risk PCa, respectively. Regarding the CPG, these values were 6.9%, 13%, 21%, and 60% for the corresponding risk groups.
CONCLUSIONS: This study underlines the importance of nuanced risk stratification, recommending the further subdivision of intermediate- and high-risk disease given the notable variation in the prevalence of metastatic disease. PSMA-PET/CT for primary staging should be reserved for patients with unfavorable intermediate- or higher-risk disease.
RESULTS: The use of various risk classification systems in patients with prostate cancer helps identify those at a higher risk of having metastatic disease on prostate-specific membrane antigen positron emission tomography/computed tomography for primary staging.
摘要：
背景：全球使用各种风险分类系统（RCS）将新诊断的前列腺癌（PCa）患者分为预后组。
目的：比较不同预后亚组的预测价值（低，中介-，和高风险疾病）在RCSs内，用于在前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）/计算机断层扫描（CT）上检测转移性疾病，并评估进一步细分分组是否有益。
方法：新诊断的PCa患者，我们对2017年至2022年期间进行PSMA-PET/CT检查的患者进行了回顾性研究.根据四个RCS将患者分为危险组：欧洲泌尿外科协会，国家综合癌症网络（NCCN）剑桥预后组（CPG），和前列腺癌的风险评估。
方法：在4个RCSs的亚组中比较PSMA-PET/CT转移性疾病的患病率。
结论：总的来说，研究了2630例新诊断为PCa的男性。在35%(931/2630)的患者中观察到任何转移性疾病。在被归类为中危和高危疾病的患者中，转移的发生率约为12%~46%.两个RCS进一步细分了这些组。根据NCCN,在5.8%中观察到转移性疾病，13%,22%,62%为有利的中间人-，不利的中介-，high,和非常高风险的PCa，分别。关于CPG，这些值是6.9%，13%,21%,以及相应风险组的60%。
结论：这项研究强调了细微差别风险分层的重要性，鉴于转移性疾病患病率的显著差异,建议进一步细分中危和高危疾病.主要分期的PSMA-PET/CT应保留给具有不利的中或高风险疾病的患者。
结果：在前列腺癌患者中使用各种风险分类系统有助于在前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描中识别具有更高转移性疾病风险的患者。
目的：比较不同预后亚组的预测价值（低，中介-，和高风险疾病）在RCSs内，用于在前列腺特异性膜抗原（PSMA）正电子发射断层扫描（PET）/计算机断层扫描（CT）上检测转移性疾病，并评估进一步细分分组是否有益。
方法：新诊断的PCa患者，我们对2017年至2022年期间进行PSMA-PET/CT检查的患者进行了回顾性研究.根据四个RCS将患者分为危险组：欧洲泌尿外科协会，国家综合癌症网络（NCCN）剑桥预后组（CPG），和前列腺癌的风险评估。
方法：在4个RCSs的亚组中比较PSMA-PET/CT转移性疾病的患病率。
结论：总的来说，研究了2630例新诊断为PCa的男性。在35%(931/2630)的患者中观察到任何转移性疾病。在被归类为中危和高危疾病的患者中，转移的发生率约为12%~46%.两个RCS进一步细分了这些组。根据NCCN,在5.8%中观察到转移性疾病，13%,22%,62%为有利的中间人-，不利的中介-，high,和非常高风险的PCa，分别。关于CPG，这些值是6.9%，13%,21%,以及相应风险组的60%。
结论：这项研究强调了细微差别风险分层的重要性，鉴于转移性疾病患病率的显著差异,建议进一步细分中危和高危疾病.主要分期的PSMA-PET/CT应保留给具有不利的中或高风险疾病的患者。
结果：在前列腺癌患者中使用各种风险分类系统有助于在前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描中识别具有更高转移性疾病风险的患者。
