Baas DJH, Schilham M, Hermsen R, et al. - For robotic-assisted radical prostatectomy (RARP) and extended pelvic LN dissection (ePLND), preoperative prostate-specific membrane antigen (PSMA)-PET/CT may be a valuable tool for patient counseling, as it is a significant predictor for the risk of postoperative biochemical persistence (BCP) and early biochemical recurrence (BCR). This study’s findings demonstrate that an ePLND should not be avoided in men with intermediate or high-risk prostate cancer and preoperative negative PSMA-PET/CT, as 20% have microscopic lymph nodes (LN) metastasis.

• Researchers found PSMA+ in 40y patients (19%).

• As per the findings, 23% was the overall incidence of pN1.

• Furthermore, 29%, 84%, 35%, and 80% were reported as sensitivity, specificity, PPV, and NPV on a per-patient level for the detection of pN1.

• They found BCP in 26 of 211 patients (12%) and early BCR in 23 of 110 patients (21%).

• It was shown that the presence of PSMA+ was a significant predictor for BCP (OR 7.1, 2.9–17.1 95% CI) and BCR (OR 8.1, 2.9–22.6 95% CI).