Tailoring Prostate Cancer Surgery
This thesis studied and confirmed that image-guided surgery in prostate cancer is an innovative way to operate with greater precision. First, a systematic review was conducted of what was known worldwide at that time. This was studied more in depth through a Delphi consensus proces with international panel members. The wishes and requirements of daily practicioners of targeted surgery were analyzed, and gave us insights in how to proceed in future research. To visualize anatomical structures, tracers can be used during surgery to identify, for example, the sentinel lymph node or the lymphatic pathways in their entirety from the prostate (and other organs). To remove the tumor-containing tissue while sparing healthy tissue, a tracer that specifically binds to the prostate-specific membrane antigen (PSMA) and is therefore selective for prostate cancer can be used. Both fluorescence and radio-guided surgery are options here. The focus of this thesis is on the advantages and disadvantages of fluorescence and radio-guided applications. The ultimate goal is to develop a prostate-specific tracer that is both fluorescent and radioactive (hybrid). The follow-up to this in the form of a “first-in-human” trial with the hybrid PSMA tracer is expected this year.
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