Predictieve waarde van SUVmax bij primair gemetastaseerd hormoonsensitief prostaatcarcinoom

Background: Oncological endpoints in patients with de novo metastatic hormone-sensitive prostate cancer (mHSPC) vary considerably. PSMA-PET/CT is increasingly used due to its higher sensitivity in primary staging of prostate cancer (PCa). Molecular parameters such as the SUVmax may add prognostic value to the currently used classification of high versus low volume metastatic disease. This study explored the relationship between SUVmax and oncological outcomes in patients with de novo mHSPC. Methods: Thirty mHSPC patients who received PSMA-PET/CT at diagnosis were retrospectively analyzed. SUVmax of the primary tumor and metastatic lesions were recorded. Primary outcomes consisted of time to castration-resistant prostate cancer (CRPC) and overall survival. Cox regression and Kaplan-Meier analyses were performed. Results: Median follow-up was 7.7 years. Twenty-three patients developed CRPC and fourteen died. SUVmax of the prostate or metastases was not associated with time to CRPC (p = 0.35 and p = 0.65, respectively) or overall survival (p = 0.70 and p = 0.30, respectively) in neither univariate nor multivariate analyses. Although an extensive follow-up was reached, the small sample-size was limited. Conclusion: In this explorative study, neither the SUVmax of the local tumor nor of the metastases was associated with the studied oncological outcomes in patients with de novo mHSPC. More research is necessary to confirm its prognostic value. Other PSMA-derived parameters may provide more accurate predictions.