Ip17-23 Impact of Psma-pet on Pelvic Lymph Node Dissection Trends in Australia: National Compared to the Largest Single-centre Cohort in Australia
Year: 2026
Type: article
Study design: Observational Study
Abstract: INTRODUCTION AND OBJECTIVES: International guidelines recommend pelvic lymph node dissection (PLND) during radical prostatectomy (RP) for nodal staging, but prostate-specific membrane antigen positron emission tomography (PSMA-PET) has improved non-invasive staging accuracy.Australia has seen widespread adoption of PSMA-PET pre-operatively since its coverage under the Medicare Benefits Scheme (MBS).We evaluated national PLND trends in Australia and compared this with PSMA-PET's impact at a high volume robotic centre in Australia.METHODS: National RP data was analysed using populationnormalized counts and Joinpoint regression.MBS item codes 37210 (RP performed without PLND) and 37211 (RP performed with PLND) in Australia from 1997 to 2024 were assessed.All statistics were normalised by expressing counts per 1,000,000 men.At Nepean Hospital (Nov 2012eAug 2024), 1000 robotic-assisted laparoscopic RP cases were reviewed; 617 had PLND.Lymph node yield and PLND rates were assessed in relation to PSMA-PET.RESULTS: Nationally, PLND declined from 75.7% (2002e2008) to 21.0% in 2024, with marked interstate variation.At Nepean Hospital, PLND declined from 100% in 2012 to 13% in 2024.PSMA-PET uptake in regional nodes strongly predicted PLND and higher lymph node yield (Mann-Whitney U test P[0.0007).After PSMA-PET MBS listing in 2022, PLND rates fell ~23% per year (Chi square p<0.05).CONCLUSIONS: PLND use in Australia has significantly declined over three decades.Based on our experiences at a specialised robotic tertiary centre, PSMA-PET avidity was a strong predictor for PLND, reflecting the important role of pre-operative noninvasive staging.
Source: The Journal of Urology
Language: English
Subfield: Urology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7156275331