Negative PSMA PET/CT does not reliably exclude microscopic pelvic lymph node metastases in intermediate- and high/very high-risk prostate cancer. These findings demonstrate a biologically relevant false-negative rate for PSMA-based nodal staging. While this study does not assess radiotherapy outcomes, the presence of occult nodal disease in PSMA-negative patients supports a cautious, risk-adapted approach to treatment de-escalation strategies involving pelvic nodal irradiation.
Authors: Alaattin Özen, Zeynep Sarikaya, Cansu Gur, Direnç Özbörü, Halil Lütfi Canat
DOI: https://doi.org/10.1002/pros.70124
Publish Year: 2026
