Abstract
The purpose of this study is to evaluate the PSMA PET imaging parameters in association with outcomes among patients with oligorecurrent prostate cancer. This retrospective single-center study included 101 patients (median age 71; interquartile range 65-75) with biochemically recurrent prostate cancer who underwent PSMA PET between May 2021 and May 2022, revealing 5 or fewer sites of metastases (oligometastatic disease). Multiple variables including maximum standardized uptake value (SUV(max)), mean standardized uptake value (SUV(mean)), and molecular tumor volume (MTV) were measured and analyzed on a per-patient basis, along with total MTV and molecular tumor burden (MTB). Multivariable Cox proportional-hazards regression models were used to identify factors associated with progression-free survival (PFS). PSMA PET revealed a total of 216 lesions across all patients, of which 134 (62.0%) involved the lymph nodes and 56 (25.9%) involved the bone. A total of 61 (60.4%) patients received combined metastasis-directed and hormone therapy, and 40 (39.6%) received hormone therapy only. The median subsequent follow-up from PSMA PET detection of oligorecurrent disease was 18.2 months (IQR 10.3-25.0). MTV on PSMA PET was associated with worse PFS (hazard ratio: 1.05, 95% CI 1.00-1.11; P = 0.04). Molecular tumor volume on PSMA PET is associated with worse clinical outcomes in patients with oligorecurrent prostate cancer.