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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 6/2018

01-06-2018 | Original Article

The relationship between local recurrences and distant metastases in prostate cancer: can 11C-choline PET/CT contribute to understand the link?

Authors: Giampiero Giovacchini, Andrea Ciarmiello, Elisabetta Giovannini, Andrei Fodor, Cesare Cozzarini, Paola Mapelli, Elena Incerti, Nadia Di Muzio, Luigi Gianolli, Maria Picchio

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 6/2018

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Abstract

Purpose

Previous studies in prostate cancer (PCa) patients tried to correlate the onset of local recurrence (LR) with the development of distant metastases and formulated, based on theoretical and experimental data, hypotheses linking the two events. We aimed to address this issue with 11C-choline positron emission tomography/computed tomography (PET/CT).

Methods

This retrospective study included 491 PCa patients previously treated with radical prostatectomy who had undergone 11C-choline PET/CT owing to biochemical failure. Further inclusion criteria were availability of clinical and pathological variables for survival analysis. Statistical significance was taken at P < 0.05.

Results

Seventy-two patients (14.7%) had evidence of LR at 11C-choline PET/CT. The frequency of LR increased from 13.8% in the interval 0–4 years after prostatectomy, to 23.9% in the 12–16-year interval (P = 0.080). On the contrary, the frequency of lymph node metastases (overall rate in the 0–16 years interval after prostatectomy: 26.3%) and of bone metastases (overall rate: 13.8%) decreased significantly over time. Kaplan-Meier curves showed no significant group difference in the rates of lymph node or bone metastases between patients with LR and patients without LR. LR significantly predicted PCa-specific survival at univariate analysis, but the statistical significance was lost at multivariate analysis.

Conclusion

We found no differences in the rates of lymph node and bone metastases between patients with and without LR. An inverse time-dependent trend was observed in the frequency of LR on one side and of lymph node and bone metastases on the other side. These findings were discussed in relation to previous theories linking LR to distant metastases and our study design.
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Metadata
Title
The relationship between local recurrences and distant metastases in prostate cancer: can 11C-choline PET/CT contribute to understand the link?
Authors
Giampiero Giovacchini
Andrea Ciarmiello
Elisabetta Giovannini
Andrei Fodor
Cesare Cozzarini
Paola Mapelli
Elena Incerti
Nadia Di Muzio
Luigi Gianolli
Maria Picchio
Publication date
01-06-2018
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 6/2018
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-018-3944-0

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