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Updated: Aug 5, 2026
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A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
Published on: November 7, 2025
Surgical Management of PSMA PET-Positive Lymph Nodes in Prostate Cancer
Andrea Cosenza1,2, Leonardo Quarta1,2, Armando Galdieri1,2
1Division of Experimental Oncology/Unit of Urology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Current Urology Reports
|July 28, 2026
Summary
Prostate cancer staging with PSMA PET identifies limited nodal metastases (miN1M0). Surgery may be feasible for selected patients, guiding individualized treatment decisions rather than automatic exclusion.
Area of Science:
- Oncology
- Nuclear Medicine
- Urology
Background:
- Prostate-specific membrane antigen (PSMA) PET imaging has advanced prostate cancer staging.
- It detects low-volume nodal metastases (miN1M0) previously occult on conventional imaging.
Purpose of the Study:
- To review current evidence on miN1M0 prostate cancer.
- To discuss factors influencing surgical decision-making in these patients.
Main Methods:
- Literature review of contemporary series and evidence on miN1M0 disease.
- Analysis of factors relevant to surgical candidacy and outcomes.
Main Results:
- Evidence on the role of surgery in miN1M0 disease is heterogeneous and undefined.
- Surgery may be feasible in selected patients as part of multimodal treatment.
- Surgical candidacy depends on nodal burden, location, local tumor extent, biology, and resectability.
Conclusions:
- miN1M0 status should prompt individualized patient selection for surgery, not automatic exclusion.
- Low-volume pelvic nodal disease is a potential surgical scenario.
- Prospective studies are needed to identify patients who benefit from surgery within multimodal care.
