Association Between the PRIMARY Score at Staging Prostate-specific Membrane Antigen Positron Emission Tomography and Overall Survival Among Patients with Newly Diagnosed Prostate Cancer: Findings from the International, Multicenter PROMISE Registry
Year: 2025
Type: article
Study design: Observational Study
Abstract: The PRIMARY score was implemented in Prostate Cancer Molecular Imaging Standardized Evaluation (PROMISE) version 2 to improve accuracy for the diagnosis of clinically significant prostate cancer using prostate-specific membrane antigen (PSMA) positron emission tomography (PET). We reviewed overall survival (OS) for patients who underwent PSMA PET for initial staging to evaluate the prognostic value of PRIMARY in a large, international, multicenter cohort. The cohort comprised 1889 patients who underwent PSMA PET for initial staging of prostate cancer at investigator sites across Europe and Australia between 2012 and 2021. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated for PRIMARY scores to identify predictors of OS. Complete-case head-to-head comparisons were conducted for Prostate Imaging-Reporting and Data System (PI-RADS) versus PRIMARY scores, and cT stage versus PRIMARY scores. We present preliminary findings up to January 31, 2025, when 231 deaths had occurred. PRIMARY score 5 (HR 1.5, 95% CI 1.0-2.3; p = 0.045) was associated with shorter OS. Improvements in C index values confirmed the added prognostic value of the PRIMARY score when combined with PI-RADS or cT stage. PRIMARY score 5 on initial PSMA PET is prognostic for shorter OS. There is ongoing long-term follow-up in the PROMISE registry (NCT06320223, promise-pet.org).
Source: European Urology
Authors: Madeleine J. Karpinski, Sebastian Hoberück, Wolfgang P. Fendler, Caner Civan, Ralph A. Bundschuh, Christian Thomas, Anders Bjartell, Elin Trägårdh, Timo F.W. Soeterik, Laura Evangelista, Andrej Vondrak, Sazan Rasul, Laura Forner, Andrea Di Giorgio, Helen Scholtissek, Jonathan Miksch, Adrien Holzgreve, Francesco Lanfranchi, Kambiz Rahbar, Michael S. Hofman, Isabel Rauscher, Osman Güven, Matthias Eiber, Narjess Ayati, Lale Umutlu, Ken Herrmann, Boris Hadaschik, Louise Emmett
Institutions: University Hospital Münster, Essen University Hospital, University Hospital Carl Gustav Carus, Technische Universität Dresden, Lund University, Skåne University Hospital, University Medical Center Utrecht, St. Antonius Ziekenhuis, Humanitas University, IRCCS Humanitas Research Hospital, Medical University of Vienna, University of Bologna, University of Augsburg, Universität Ulm, University Hospital Ulm, University of California, Los Angeles, LMU Klinikum, Ludwig-Maximilians-Universität München, University of Genoa, The University of Melbourne, Peter MacCallum Cancer Centre, TUM Klinikum, Technical University of Munich, St Vincent's Hospital Sydney
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,250
OpenAlex ID: W4415675624