{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T03:26:08Z","timestamp":1793676368750,"version":"4.5.1"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"13","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"University of Innsbruck and Medical University of Innsbruck","id":[{"id":"https:\/\/ror.org\/054pv6659","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>PSMA PET\/CT has transformed the detection of nodal recurrence after radical prostatectomy, yet real-world evidence on long-term outcomes of PSMA PET\/CT-guided salvage elective nodal radiotherapy (ENRT) remains limited. This study evaluated oncological outcomes of PSMA PET\/CT-guided salvage ENRT in a bi-institutional cohort with extended follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed 179 patients who received PSMA PET\/CT-based ENRT for nodal recurrence after radical prostatectomy at two tertiary centres between 2014 and 2024. Patients with pelvic and\/or paraaortic lymph node metastases were included. The primary endpoint was metastasis-free survival (MFS); secondary endpoints included biochemical progression-free survival (BPFS) and overall survival (OS). Survival outcomes were estimated using the Kaplan\u2013Meier method, and prognostic factors were assessed using Cox regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 179 patients, 104 (58.1%) had true biochemical recurrence after radical prostatectomy, whereas 75 (41.9%) had PSA persistence. After a median follow-up of 60.3 months, 5-year MFS and BPFS rates were 74.3% and 62.3%, respectively, in patients with true biochemical recurrence, compared with 61.2% and 56.4% in the overall cohort. In multivariable analyses of the entire cohort, concomitant ADT was associated with improved MFS (HR 0.36,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and BPFS (HR 0.26,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), compared with no ADT. PSA persistence after surgery was associated with worse outcomes (MFS: HR 2.72,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; BPFS: HR 2.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PSMA PET\/CT-guided salvage ENRT predominantly combined with ADT provides durable long-term disease control in patients with nodal recurrence in routine clinical practice. In patients with true recurrence after radical prostatectomy, the 5-year MFS rate was 74.3%, approaching outcomes reported in prospective trials. However, the absence of systematically collected clinician-assessed toxicity and patient-reported outcomes precludes a reliable assessment of treatment tolerability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-08147-z","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T01:41:26Z","timestamp":1788486086000},"page":"8478-8487","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["PSMA PET\/CT-guided salvage elective nodal radiotherapy for nodal metastases after radical prostatectomy: a bi-institutional long-term outcome analysis"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1711-1604","authenticated-orcid":false,"given":"Samuel M.","family":"Vorbach","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Seppi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6565-0686","authenticated-orcid":false,"given":"Giulia","family":"Santo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7097-6170","authenticated-orcid":false,"given":"Irene","family":"Virgolini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ute","family":"Ganswindt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Keilholz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah Frederike","family":"Brose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozefina","family":"Casuscelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Klimek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina-Sophie","family":"Schmidt-Hegemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus","family":"Belka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Trapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3351-8896","authenticated-orcid":false,"given":"Paul","family":"Rogowski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"issue":"12","key":"8147_CR1","doi-asserted-by":"publisher","first-page":"1972","DOI":"10.2967\/jnumed.117.196683","volume":"58","author":"L Emmett","year":"2017","unstructured":"Emmett L, et al. 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All other authors declare that they have no financial or non-financial conflicts of interest. This study was performed in accordance with the local ethical standards.","order":2,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}