Updated Prostate Cancer Risk Groups by Prostate-specific Membrane Antigen Positron Emission Tomography Prostate Cancer Molecular Imaging Standardized Evaluation (PPP2): Results from an International Multicentre Registry Study

作者：Madeleine J. Karpinski, Kambiz Rahbar, Martin Bögemann, Laya Rahbar Nikoukar, Michael Schäfers, Sebastian Hoberück, Matthias Miederer, Tobias Hölscher, Sazan Rasul, Marcin Miszczyk, Francesco Lanfranchi, Matteo Bauckneht, Christian H. Pfob, Felix Kind, Karolien Goffin, Anika Hüsing, Claudia Kesch, Ken Herrmann, Martin Stuschke, Andrei Gafita, Johannes Hüsing, Jérémie Calais, Michael S. Hofman, Thomas A. Hope, Jonathan Miksch, Timo Soeterik, Andrea Di Giorgio, Andrea Farolfi, Anders Bjartell, Elin Trägårdh, Lena M. Unterrainer, Adrien Holzgreve, Gabriel T. Sheikh, Isabel Rauscher, Matthias Eiber, Boris Hadaschik, Wolfgang P. Fendler, Nadir Rodriguez SantAnna Jauregui, Marcus Hacker, Shahrokh F. Shariat, Giuseppe Fornarini, Carlo Terrone, Niloefar Ahmadi Bidakhvidi, Laura Evangelista, Alfonso Santangelo, Andrej Vondrak, Harm H.E. van Melick, Marco Rapa, Lorenzo Bianchi, Anniqa Rastbäck, Åsa Andersson, Sophie C. Kunte, Lukas Späth, Linus Hempel, Ömür Coban · 发表于：European Urology · 年份：2025 · DOI：10.1016/j.eururo.2025.04.017 · 被引用次数：25 · 研究领域：Prostate Cancer Treatment and Research、Prostate Cancer Diagnosis and Treatment、Radiopharmaceutical Chemistry and Applications

BACKGROUND AND OBJECTIVE: We established prognostic nomograms incorporating prostate-specific membrane antigen (PSMA) positron emission tomography (PET) parameters standardised by Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE; PPP1). Here, we develop an updated PPP2 risk score from a large international multicentre registry study. METHODS: We included 6128 prostate cancer patients who underwent PSMA-PET at 20 hospitals in Europe, USA, and Australia between 2013 and 2022. Investigator sites were split 2:1 into the development (4044 patients) and validation (2084 patients) cohorts. We created nomograms of version 2 (PPP2) based on Cox regression models with the least absolute shrinkage and selection operator penalty for overall survival (development cohort). Performance of both nomograms was measured using Harrell's C-index and calibration plots and a head-to-head comparison with the National Comprehensive Cancer Network (NCCN) risk score by receiver operating characteristic curves (validation cohort). KEY FINDINGS AND LIMITATIONS: Predictors were distant metastases (extrapelvic nodal metastases [M1a], bone metastases [M1b], and visceral metastases [M1c]), PSMA expression score, and total lesion count (visual PPP2) or total tumour volume (quantitative PPP2). C-indices (95% confidence interval) in the validation cohort were 0.80 (0.78-0.82; visual) and 0.80 (0.79-0.82; quantitative), respectively. Accuracy of both the PPP2 nomograms was superior to the NCCN ...