PSMA-Guided Surgery Shows Biochemical Responses
A post hoc analysis of the TRACE-I trial links PSMA-guided salvage surgery for recurrent prostate cancer to PSA decline but limited long-term control.
Updated on Nov. 10, 2026 in Men’s Health
A post hoc analysis of the TRACE-I trial, published August 29, 2026, in European Urology Focus, found that robot-assisted PSMA-radioguided salvage surgery was associated with PSA decline in 93% of 30 patients with biochemical recurrence. Biochemical progression-free survival was 40% at 12 months and 30% at 24 months.
Why it matters
Men whose prostate cancer returns after surgery or radiation have limited options, and salvage surgery aimed at PSMA-avid lesions may offer a targeted approach. The modest long-term control seen in this small analysis underscores the need for prospective comparative research to identify which patients benefit most.
The analysis covered 30 patients, with 94% of PSMA-avid lesions identified and 97% successfully resected, though 33% developed postoperative complications. Biochemical progression-free survival fell to 40% at 12 months and 30% at 24 months, and the authors note that prospective comparative research is still needed.
The players
Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital
A leading Amsterdam cancer center whose investigators conducted the TRACE-I analysis and are active in prostate cancer imaging and surgical research.
The details
Investigators at the Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital in Amsterdam used a technetium-99m-labeled PSMA tracer and a DROP-IN gamma probe to localize lesions during robot-assisted surgery. Histopathology revealed additional lesions in 7 patients, and most complications were Clavien-Dindo grade 1 events.
Timeline
Median interval of 62 months between prior treatment and salvage surgery
First postoperative PSA assessment performed within 6-12 weeks of surgery
Median follow-up of 39 months
Study published online August 29, 2026
Health Landscape
The TRACE-I trial is an active prostate cancer research program testing PSMA-guided treatment in men with recurrent disease. This post hoc analysis adds a focused look at salvage surgery, a treatment approach still being evaluated against other options for men whose cancer returns after initial therapy.
Men whose prostate cancer returns after surgery or radiation may one day be offered imaging-guided salvage surgery, though this approach is not yet standard. Patients considering treatment options should discuss with their oncologist whether clinical trials or established therapies better fit their situation.
The takeaway
Imaging-guided surgery can reliably find cancer that returns after initial treatment, but how long it keeps the disease in check is still an open question. Patients should weigh early biochemical responses against the need for longer-term evidence before choosing an option.
Further reading
Explore more on Men’s Health for context on prostate cancer care and treatment research.
