A NEW study has found that PET/CT scans using an experimental prostate-specific membrane antigen (PSMA) imaging agent can identify supraclavicular (SC) nodal metastasis in newly diagnosed prostate cancer patients. Researchers based in Nairobi, Kenya, have reported that SC lymph node metastases were detected in 8% of a large cohort of patients, suggesting that this site should be considered during initial diagnostic assessments.
“To the best of our knowledge, this is the first study reporting a significant prevalence of SC nodal metastasis in newly diagnosed prostate cancer patients,” noted the authors of the study.
While most metastatic prostate cancer cases involve bone and regional lymph node metastases, researchers noted that metastases at atypical sites, such as SC lymph nodes, are not uncommon. However, little literature exists on the prevalence of disease in these nodes among prostate cancer patients.
To address this gap, the team analysed PET/CT scans of 998 patients who underwent imaging with the F-18 PSMA-1007 radiotracer at their hospital between June 2020 and June 2022. They focused on 240 patients undergoing scans for primary staging of newly diagnosed prostate cancer.
The median age of patients was 68 years, with a median PSA level at diagnosis of 37. The majority presented with stage IV disease and were classified as high or very high risk.
Findings revealed that 7.9% (19 out of 240) had SC nodal metastasis. Among them, 84% also had skeletal metastases, and one patient had associated visceral metastasis in the lungs. The study established a strong link between advanced-stage prostate cancer and the presence of SC nodal metastases.
Late-stage prostate cancer diagnosis is common in sub-Saharan Africa, partly due to delays in diagnosis and the aggressive nature of the disease in men of African descent compared to Caucasians.
Given these findings, researchers recommend that SC lymph nodes should be routinely considered in diagnostic workups and follow-ups for prostate cancer patients. Further research is needed to determine whether detecting metastases in these sites has prognostic implications.
“The prognostic significance of supraclavicular nodal metastasis in prostate cancer requires further research,” the team concluded.
Reference
Gitau SN et al. Supraclavicular nodal metastasis at primary staging of prostate cancer using 18F-PSMA-1007 PET/CT. EJNMMI Rep. 2025;9(1):9.
