{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:52:56Z","timestamp":1788497576259,"version":"build-2803163510"},"reference-count":53,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T00:00:00Z","timestamp":1760745600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prostate\u2010specific membrane antigen positron emission tomography\/computed tomography (PSMA\u2010PET\/CT) is affecting the management of patients with prostate cancer with biochemical recurrence after radical prostatectomy. The long\u2010term outcomes of tailoring salvage treatment on the basis of PSMA\u2010PET\/CT status remain to be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A decision\u2010analytic model was developed to project incremental life\u2010years of strategies that allocate treatments at biochemical recurrence after radical prostatectomy on the basis of PSMA\u2010PET\/CT status (PSMA\u2010metastatic vs. PSMA\u2010nonmetastatic). Modeled treatments are local\/regional (radiation) or systemic (hormone therapy and doublet therapy), administered immediately or delayed. PSMA\u2010metastatic status was assumed to lead to treatment intensification, whereas PSMA\u2010nonmetastatic status would lead to deintensification. To project survival, data on progression to metastasis from a clinical cohort were combined with registry data on postmetastasis survival. Because of the lack of data on long\u2010term treatment benefits by PSMA status, survival was projected by varying the hazard ratio (HR) for disease\u2010specific death among PSMA\u2010metastatic versus PSMA\u2010nonmetastatic patients under delayed or local\/regional regimens (HR1) and under immediate systemic regimens (HR2).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean life\u2010years are projected to be 15.5 under the non\u2013PSMA\u2010tailored strategy, and mean incremental life\u2010years range from 0.38 to 0.81 depending on HR1 and HR2. A greater benefit is projected when PSMA\u2010metastatic status is more adverse under salvage regimens that do not include systemic agents.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This decision\u2010analytic modeling study projects that PSMA\u2010PET\/CT\u2013guided management at biochemical recurrence after radical prostatectomy yields a modest survival benefit under the specified model inputs and assumptions regarding treatment distributions. These findings may complement emerging data on the corresponding economic costs and health\u2010related quality of life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.70131","type":"journal-article","created":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T16:15:18Z","timestamp":1760804118000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prostate\u2010specific membrane antigen positron emission tomography\/computed tomography imaging as a precision diagnostic at prostate cancer recurrence after radical prostatectomy: Modeling long\u2010term survival"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8474-4039","authenticated-orcid":false,"given":"Kemal Caglar","family":"Gogebakan","sequence":"first","affiliation":[{"name":"Public Health Sciences Division Fred Hutchinson Cancer Center  Seattle Washington 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