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The negative effect was caused by lower QoL and high costs in the false palliative state, due to pN1 patients (≤ 4 pelvic lymph node metastases) being falsely diagnosed as iN1 ( 4 pelvic lymph node metastases). These patients received subsequently palliative treatment instead of potentially curative therapy. Initial staging and treatment planning based on [ Ga]Ga-PSMA-11 PET/CT saves cost but results in small QALY loss due to the rate of false positive findings. Initial staging and treatment planning based on [6