{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:49:42Z","timestamp":1790171382077,"version":"4.1.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T00:00:00Z","timestamp":1736121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Prostate Cancer Prostatic Dis"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prostate-specific membrane antigen (PSMA) positron emission tomography (PET) has a high negative predictive value (NPV) in determining lymph node invasion (LNI) in men with intermediate-risk disease undergoing radical prostatectomy (RP) and pelvic lymph node dissection (PLND). We hypothesized that PSMA PET may be used to reduce the number of unnecessary PLND procedures performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess BCR-free survival of intermediate risk prostate cancer patients with a negative PSMA PET who underwent PLND vs. no PLND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, and participants<\/jats:title>\n                    <jats:p>Within a high-volume center database, we identified patients with Grade Group 2-3 and PSA\u2009\u2264\u200920\u2009ng\/ml who had a negative PSMA PET prior to RP between 2016 and 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measurements and statistical analysis<\/jats:title>\n                    <jats:p>Kaplan\u2013Meier analyses were used to compare BCR-free survival between patients with and without PLND.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results and limitations<\/jats:title>\n                    <jats:p>\n                      Overall, 371 patients were identified. Of those, 333 (90%) underwent RP with PLND, while 38 (10%) had no PLND during RP. Median number of removed lymph nodes in patients with PLND was 16. The NPV of PSMA PET for LNI detection was 90.1%. Median follow-up was 36 months. The median preoperative PSA was 7.8\u2009ng\/ml. 59% had biopsy Grade Group 2 and 41% had biopsy Grade Group 3, respectively. BCR-free survival at 36 months after prostatectomy was 78.7% vs. 76.7% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.8) for patients with vs. without PLND. Main limitation is the absence of long-term oncologic outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In intermediate risk prostate cancer patients, a PLND may be avoided in the presence of a negative PSMA PET.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41391-024-00930-z","type":"journal-article","created":{"date-parts":[[2025,1,6]],"date-time":"2025-01-06T06:35:14Z","timestamp":1736145314000},"page":"874-878","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Negative PSMA PET can be used to avoid unnecessary pelvic lymph node dissection in intermediate risk prostate cancer"],"prefix":"10.1038","volume":"28","author":[{"given":"Reha-Baris","family":"Incesu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Preisser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Nohe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5660-7691","authenticated-orcid":false,"given":"Tobias","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Graefen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7033-1380","authenticated-orcid":false,"given":"Derya","family":"Tilki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,6]]},"reference":[{"key":"930_CR1","unstructured":"Kong J, Lichtbroun B, Sterling J, Wang Y, Wang Q, Singer EA et al. Comparison of perioperative complications for extended vs standard pelvic lymph node dissection in patients undergoing radical prostatectomy for prostate cancer: a meta-analysis. 2022 www.ajceu.us\/."},{"key":"930_CR2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.euo.2021.08.001","volume":"5","author":"A Stabile","year":"2022","unstructured":"Stabile A, Pellegrino A, Mazzone E, Cannoletta D, de Angelis M, Barletta F, et al. Can Negative Prostate-specific Membrane Antigen Positron Emission Tomography\/Computed Tomography Avoid the Need for Pelvic Lymph Node Dissection in Newly Diagnosed Prostate Cancer Patients? A Systematic Review and Meta-analysis with Backup Histology as Reference Standard. Eur Urol Oncol. 2022;5:1\u201317.","journal-title":"Eur Urol Oncol"},{"key":"930_CR3","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.eururo.2009.05.044","volume":"56","author":"L Bud\u00e4us","year":"2009","unstructured":"Bud\u00e4us L, Isbarn H, Schlomm T, Heinzer H, Haese A, Steuber T, et al. Current Technique of Open Intrafascial Nerve-Sparing Retropubic Prostatectomy. Eur Urol. 2009;56:317\u201324.","journal-title":"Eur Urol"},{"key":"930_CR4","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.eururo.2011.02.040","volume":"60","author":"T Schlomm","year":"2011","unstructured":"Schlomm T, Heinzer H, Steuber T, Salomon G, Engel O, Michl U, et al. Full Functional-Length Urethral Sphincter Preservation During Radical Prostatectomy. Eur Urol. 2011;60:320\u20139.","journal-title":"Eur Urol"},{"key":"930_CR5","doi-asserted-by":"publisher","first-page":"1031","DOI":"10.1111\/bju.14760","volume":"123","author":"A Haese","year":"2019","unstructured":"Haese A, Knipper S, Isbarn H, Heinzer H, Tilki D, Salomon G, et al. A comparative study of robot-assisted and open radical prostatectomy in 10 790 men treated by highly trained surgeons for both procedures. BJU Int. 2019;123:1031\u201340.","journal-title":"BJU Int"},{"key":"930_CR6","unstructured":"R Core Team. R: A language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing; 2022. https:\/\/www.R-project.org\/."},{"key":"930_CR7","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1016\/j.eururo.2020.11.040","volume":"79","author":"JFP Lestingi","year":"2021","unstructured":"Lestingi JFP, Guglielmetti GB, Trinh QD, Coelho RF, Pontes J, Bastos DA, et al. Extended Versus Limited Pelvic Lymph Node Dissection During Radical Prostatectomy for Intermediate- and High-risk Prostate Cancer: Early Oncological Outcomes from a Randomized Phase 3 Trial. Eur Urol. 2021;79:595\u2013604.","journal-title":"Eur Urol"},{"key":"930_CR8","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1007\/s00345-018-2182-1","volume":"36","author":"J Corfield","year":"2018","unstructured":"Corfield J, Perera M, Bolton D, Lawrentschuk N. 68Ga-prostate specific membrane antigen (PSMA) positron emission tomography (PET) for primary staging of high-risk prostate cancer: a systematic review. World J Urol. 2018;36:519\u201327.","journal-title":"World J Urol"},{"key":"930_CR9","doi-asserted-by":"publisher","first-page":"214","DOI":"10.2967\/jnumed.120.245605","volume":"62","author":"S Klingenberg","year":"2021","unstructured":"Klingenberg S, Jochumsen MR, Ulh\u00f8i BP, Freds\u00f8e J, S\u00f8rensen KD, Borre M, et al. 68Ga-PSMA PET\/CT for primary lymph node and distant metastasis NM staging of high-risk prostate cancer. J Nucl Med. 2021;62:214\u201320.","journal-title":"J Nucl Med"},{"key":"930_CR10","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.1097\/JU.0000000000001592","volume":"205","author":"D Meijer","year":"2021","unstructured":"Meijer D, de Barros HA, van Leeuwen PJ, Bodar YJL, van der Poel HG, Donswijk ML, et al. The Predictive Value of Preoperative Negative Prostate Specific Membrane Antigen Positron Emission Tomography Imaging for Lymph Node Metastatic Prostate Cancer. J Urol. 2021;205:1655\u201362.","journal-title":"J Urol"},{"key":"930_CR11","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1097\/JU.0000000000001698","volume":"206","author":"KJ Pienta","year":"2021","unstructured":"Pienta KJ, Gorin MA, Rowe SP, Carroll PR, Pouliot F, Probst S, et al. A Phase 2\/3 Prospective Multicenter Study of the Diagnostic Accuracy of Prostate Specific Membrane Antigen PET\/CT with 18F-DCFPyL in Prostate Cancer Patients (OSPREY). J Urol. 2021;206:52\u201361.","journal-title":"J Urol"},{"key":"930_CR12","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.euf.2021.01.004","volume":"7","author":"T Esen","year":"2021","unstructured":"Esen T, Falay O, Tarim K, Armutlu A, Koseoglu E, Kilic M, et al. 68Ga-PSMA-11 Positron Emission Tomography\/Computed Tomography for Primary Lymph Node Staging Before Radical Prostatectomy: Central Review of Imaging and Comparison with Histopathology of Extended Lymphadenectomy. Eur Urol Focus. 2021;7:288\u201393.","journal-title":"Eur Urol Focus"},{"key":"930_CR13","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1007\/s00259-020-04974-w","volume":"48","author":"BHE Jansen","year":"2021","unstructured":"Jansen BHE, Bodar YJL, Zwezerijnen GJC, Meijer D, van der Voorn JP, Nieuwenhuijzen JA, et al. Pelvic lymph-node staging with 18F-DCFPyL PET\/CT prior to extended pelvic lymph-node dissection in primary prostate cancer - the SALT trial. Eur J Nucl Med Mol Imaging. 2021;48:509\u201320.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"930_CR14","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1016\/j.juro.2015.12.025","volume":"195","author":"T Maurer","year":"2016","unstructured":"Maurer T, Gschwend JE, Rauscher I, Souvatzoglou M, Haller B, Weirich G, et al. Diagnostic Efficacy of 68Gallium-PSMA Positron Emission Tomography Compared to Conventional Imaging for Lymph Node Staging of 130 Consecutive Patients with Intermediate to High Risk Prostate Cancer. J Urol. 2016;195:1436\u201343.","journal-title":"J Urol"},{"key":"930_CR15","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1111\/bju.13540","volume":"119","author":"PJ van Leeuwen","year":"2017","unstructured":"van Leeuwen PJ, Emmett L, Ho B, Delprado W, Ting F, Nguyen Q, et al. Prospective evaluation of 68Gallium-prostate-specific membrane antigen positron emission tomography\/computed tomography for preoperative lymph node staging in prostate cancer. BJU Int. 2017;119:209\u201315.","journal-title":"BJU Int"},{"key":"930_CR16","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2021.759070.","volume":"8","author":"M Wenzel","year":"2021","unstructured":"Wenzel M, Preisser F, Hoeh B, Welte MN, Humke C, Wittler C, et al. Influence of Biopsy Gleason Score on the Risk of Lymph Node Invasion in Patients With Intermediate-Risk Prostate Cancer Undergoing Radical Prostatectomy. Front Surg. 2021;8:759070. https:\/\/doi.org\/10.3389\/fsurg.2021.759070.","journal-title":"Front Surg"},{"key":"930_CR17","doi-asserted-by":"publisher","first-page":"1663","DOI":"10.1097\/JU.0000000000001596","volume":"205","author":"T Amiel","year":"2021","unstructured":"Amiel T, W\u00fcrnschimmel C, Heck M, Horn T, Nguyen N, Bud\u00e4us L, et al. Regional Lymph Node Metastasis on Prostate Specific Membrane Antigen Positron Emission Tomography Correlates with Decreased Biochemical Recurrence-Free and Therapy-Free Survival after Radical Prostatectomy: A Retrospective Single-Center Single-Arm Observational Study. J Urol. 2021;205:1663\u201370.","journal-title":"J Urol"},{"key":"930_CR18","doi-asserted-by":"publisher","first-page":"330","DOI":"10.1111\/bju.15881","volume":"131","author":"D Meijer","year":"2023","unstructured":"Meijer D, Ettema RH, van Leeuwen PJ, van der Kwast TH, van der Poel HG, Donswijk ML, et al. The prognostic value of lymph node staging with prostate-specific membrane antigen (PSMA) positron emission tomography\/computed tomography (PET\/CT) and extended pelvic lymph node dissection in node-positive patients with prostate cancer. BJU Int. 2023;131:330\u20138. https:\/\/doi.org\/10.1111\/bju.15881.","journal-title":"BJU Int"},{"key":"930_CR19","doi-asserted-by":"publisher","unstructured":"Hofman MS, Lawrentschuk N, Francis RJ, Tang C, Vela I, Thomas P et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer before curative-intent surgery or radiotherapy (proPSMA): a prospective, randomised, multi-centre study. Lancet. 2020. https:\/\/doi.org\/10.1016\/S0140-6736(20)30314-7.","DOI":"10.1016\/S0140-6736(20)30314-7"}],"container-title":["Prostate Cancer and Prostatic Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41391-024-00930-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41391-024-00930-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41391-024-00930-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:04:40Z","timestamp":1764083080000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41391-024-00930-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,6]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["930"],"URL":"https:\/\/doi.org\/10.1038\/s41391-024-00930-z","relation":{},"ISSN":["1365-7852","1476-5608"],"issn-type":[{"value":"1365-7852","type":"print"},{"value":"1476-5608","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,6]]},"assertion":[{"value":"20 July 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"All methods were performed in accordance with the relevant guidelines and regulations. The study was conducted in accordance with the Declaration of Helsinki, and approved by the Institutional Review Board of the University Hospital Hamburg Eppendorf. Because this is a retrospective study, there is no approval number for each study. Informed consent was obtained from all subjects involved in the study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}}]}}