Pd39-01 the Suitability of Hemi-Ablation for Patients Diagnosed With Localised Prostate Cancer Following Multiparametric Mri Targeted and Non-Targeted Transperineal Prostate Biopsy

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (PD39)1 May 2024PD39-01 THE SUITABILITY OF HEMI-ABLATION FOR PATIENTS DIAGNOSED WITH LOCALISED PROSTATE CANCER FOLLOWING MULTIPARAMETRIC MRI TARGETED AND NON-TARGETED TRANSPERINEAL PROSTATE BIOPSY Deepika Reddy, David Eldred-Evans, Mathias Winkler, Taimur Shah, and Hashim U. Ahmed Deepika ReddyDeepika Reddy , David Eldred-EvansDavid Eldred-Evans , Mathias WinklerMathias Winkler , Taimur ShahTaimur Shah , and Hashim U. AhmedHashim U. Ahmed View All Author Informationhttps://doi.org/10.1097/01.JU.0001008924.16121.42.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Evidence reporting comparable medium-term outcomes following focal therapy versus radical treatment modalities for localised prostate cancer is growing. Within the UK and Europe, despite being permitted if outcomes are prospectively collected, focal cryotherapy and High Intensity Focussed Ultrasound (HIFU) is only available in select centres. It is possible that not all patients suitable for focal therapy are referred for consideration for such treatment at select tertiary centres as the proportion of potentially suitable patients once diagnosed with localised prostate cancer is not widely understood. We determined how many patients diagnosed with localised prostate cancer following MRI and transperineal prostate biopsy in multiple prospective observational studies could be suitable for hemi-ablation. METHODS: Patients recruited into PICTURE trial, PROMIS trial, and RAPID pilot pathway were evaluated. Suitability was determined according to the Delphi Consensus criteria: PSA ≤20ng/ml, ≤rT3aN0, Gleason Grade Group (GGG) ≤3, if highest(GGG) was 1 then cancer length must be ≥6mm, and treatment pattern allowed up to unilateral hemi-ablation and spared at least 1 neurovascular bundle. Primary outcome allowed up to 5mm GGG1 to be untreated, secondary outcome allowed up to 5mm GGG1±1 core of 3+4 to remain untreated. Each study obtained local or external Research and Ethics approval. RESULTS: 200/330(61%) of patients recruited into PICTURE were diagnosed with ≤rT3aN0 prostate cancer and PSA ≤20ng/ml. 146/200(73%) had either GGG 2 or 3, or 1 with MCCL≥6mm, 3 had GGG>3, 51 had GGG13, 91 had GGG13, 103/612 had GGG1<6mm. 309/612(50%) had disease suitable for hemi-ablation, 41 of whom would have untreated GGG1<6mm disease. When allowing for 5mm GG1±1 core of 3+4 to remain untreated 313/612(51%) were suitable for hemi-ablation. CONCLUSIONS: Independent of varying incidence of prostate cancer within the cohorts evaluated, once diagnosed with localised disease between 5 and 6 patients out of 10 could be considered suitable for focal treatment, thus patients should be counselled and referred accordingly. Source of Funding: Nil © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e813 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Deepika Reddy More articles by this author David Eldred-Evans More articles by this author Mathias Winkler More articles by this author Taimur Shah More articles by this author Hashim U. Ahmed More articles by this author Expand All Advertisement PDF downloadLoading ...