Would you omit pelvic XRT in a high risk prostate patient with negative nodal uptake on PSMA but has risk of nodal involvement >15% by nomogram?

Based on POP-RT, if they are a high-risk group, I would add pelvic RT.

Agree with @Dr. First Last - this was precisely the question/population studied in POP-RT. Which nomogram to use is controversial, and POP-RT used the Roach formula with a >20% threshold. The question stem does not specify the risk model used, and the 15% threshold adds some controversy, in which ca...

No. In fact, the vast majority of the patients in the POP-RT study had negative PSMA scans!

No way. I even treat the nodes in unfavorable intermediate with high Decipher and negative PET. The reason is OSPREY, which evaluated Pylarify preop in high risk. PyL (and likely Illucex) lack sensitivity for pelvic nodes, particularly less than 5 mm. Specificity was excellent as anticipated, but a ...