{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T01:46:18Z","timestamp":1766454378851,"version":"3.48.0"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T00:00:00Z","timestamp":1765324800000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJUI Compass"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To explore the distribution of metastatic disease in pN1 patients with biochemical recurrence (BCR) assessed by Prostate\u2010Specific Membrane Antigen\u2010Positron\u2010Emission\/Computed Tomography (PSMA\u2010PET\/CT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>This multicentre, retrospective cohort study included 130 pN1 PCa patients with BCR (PSA\u2009\u2265\u20090.2\u00a0ng\/ml) post\u2010RP with ePLND (2015\u20132022). All were preoperatively staged as molecular imaging (mi)N0M0 and underwent restaging PSMA\u2010PET\/CT at BCR. Clinical and imaging data were analysed using Mann\u2013Whitney U, chi\u2010square tests and Cox regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median time to BCR was 9\u00a0months (IQR 3\u201318). Biochemical persistence (BCP) (PSA\u2009\u2265\u20090.1\u00a0ng\/ml at first follow\u2010up) occurred in 66\/130 (51%). At restaging PSMA\u2010PET\/CT, median PSA was 0.33\u2009ng\/ml (IQR 0.24\u20130.65). PSMA\u2010PET\/CT identified metastases in 63\/130 (48%), with 37\/63 (59%) having lymph node metastases (LNMs) limited to the ePLND template \u2013 16\/37 (43%) on the ipsilateral side of the positive resected node. Additionally, 26\/63 (41%) had disease beyond the nodal template (miM+). Univariate Cox regression identified BCP as a predictor for any PSMA\u2010PET\/CT\u2010detected recurrence, while a higher ISUP grade group at RP predicted miM+ disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PSMA\u2010PET\/CT identified PSMA\u2010expressing recurrent disease in nearly half of pN1 PCa patients at early BCR, with about half confined to the pelvis and a quarter beyond the pelvis. These anatomical patterns indicate that PSMA\u2010PET\/CT can inform risk\u2010adapted salvage strategies, including pelvic radiotherapy for nodal recurrences and systemic treatment when disease extends beyond the pelvis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bco2.70123","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T13:38:29Z","timestamp":1765373909000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomical distribution of disease in pN1 prostate cancer with BCR post\u2010RP: A PSMA\u2010PET\/CT\u2010based analysis"],"prefix":"10.1002","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7392-1626","authenticated-orcid":false,"given":"Lotte G.","family":"Zuur","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology (Urology) Netherlands Cancer Institute  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katelijne C. C.","family":"de Bie","sequence":"additional","affiliation":[{"name":"Department of Urology Amsterdam University Medical Centre  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lieke","family":"Wever","sequence":"additional","affiliation":[{"name":"Department of Urology Amsterdam University Medical Centre  Amsterdam the Netherlands"},{"name":"Department of Urology Canisius Wilhelmina Hospital  Nijmegen the Netherlands"},{"name":"Department of Urology St. Antonius Hospital, Utrecht  Nieuwegein the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne\u2010Claire","family":"Berrens","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology (Urology) Netherlands Cancer Institute  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean\u2010Paul A.","family":"van Basten","sequence":"additional","affiliation":[{"name":"Department of Urology Canisius Wilhelmina Hospital  Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harm H. E.","family":"van Melick","sequence":"additional","affiliation":[{"name":"Department of Urology St. Antonius Hospital, Utrecht  Nieuwegein the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten L.","family":"Donswijk","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Netherlands Cancer Institute  Amsterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9447-2305","authenticated-orcid":false,"given":"Daniela E.","family":"Oprea\u2010Lager","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging Radboud University Medical Center  Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter V.","family":"Vogel","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Netherlands Cancer Institute  Amsterdam the Netherlands"},{"name":"Department of Radiation Oncology Netherlands Cancer 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