Mp25-01 Focal Therapy for Prostate Cancer: A Treatment Option Reserved for the Ideal Candidate?

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-01 FOCAL THERAPY FOR PROSTATE CANCER: A TREATMENT OPTION RESERVED FOR THE IDEAL CANDIDATE? Daniele Cignoli, Andrea Rodriguez-Serrano, David Lopez, Armando Stabile, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Camille Lanz, Eric Barret, François Rozet, Petr Macek, Xavier Cathelineau, and Lara Rodriguez-Sanchez Daniele CignoliDaniele Cignoli , Andrea Rodriguez-SerranoAndrea Rodriguez-Serrano , David LopezDavid Lopez , Armando StabileArmando Stabile , Andrea SaloniaAndrea Salonia , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , Camille LanzCamille Lanz , Eric BarretEric Barret , François RozetFrançois Rozet , Petr MacekPetr Macek , Xavier CathelineauXavier Cathelineau , and Lara Rodriguez-SanchezLara Rodriguez-Sanchez View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Concerning FT inclusion criteria for PCa, our aim was to assess the consequences of treating patients who do not meet the ideal FT candidate profile due to non-compliance with all the inclusion criteria recommended by the FT community. METHODS: 282 pts treated with HIFU or cryotherapy for ISUP 1-2 PCa at one European center (2009-2018) were retrospectively analyzed. Pts were divided into 3 groups:G1=perfect candidates (30 pts) (ISUP 2, PSA<15ng/ml, MRI single visible lesions≤12 mm, max 1 positive core ISUP 1 outside target lesion); G2=ISUP 1 (181 pts);G3=ISUP 2 not included in G1 (71 pts). Furthermore, a sub-analysis only considering ISUP 2 pts was conducted, comparing G1 to pts who were not ideal candidates for only one single criterion. These were divided into 3 groups: SG2=with a single MRI lesion ≥12mm (5 pts); SG3=with more than 1 lesion at MRI (8 pts); SG4=with more than 1 positive core outside target (28 pts). Inverse Probability of Treatment Weighting (IPTW) was employed to compare groups in terms of recurrence-Free Survival (RFS, defined as a ≥ISUP2 positive biopsy during follow-up FU, ISUP1 was considered recurrence only in case of infield location for pts of G2), Treatment-Free Survival (TFS, defined as the need for a second treatment, whether focal or radical) and Progression-Free Survival (PFS, local progression or distant metastasis). RESULTS: No differences were found between groups in terms of pts' baseline characteristics, except for PCa's specific features. Median FU was 75 mos (IQR: 54-105). Overall, 187pts (66%) had recurrence; 77% of G1, 60% of G2 and 78% of G3. Among recurrences 65% of G1, 62% of G2 and 60% of G3 were infield; outfield in 4% of G1, 14% of G2 and 9% of G3; remaining both infield and outfield. 161pts (57%) needed additional treatments after FT (60% of G1, 54% of G2 and 65% of G3). RFS and TFS were higher for G2 68mos (95%CI 52-90), p<0.001 and 87mos (95%CI 70-101), p=0.04, but no differences were found between G1 18mos (95%CI 13-56) and 50mos (95%CI 35-NA) and G3 34mos (95%CI 26-49) and 50mos (95%CI 40-63). No differences were found in terms of PFS. Furthermore, in the sub-analysis, no differences were found in terms of RFS, TFS and PFS between G1 and all subgroups. CONCLUSIONS: Expanding FT inclusion criteria appears safe and acceptable, allowing more patients to benefit from FT. Further and multicentre studies are needed. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e403 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Daniele Cignoli More articles by this author Andrea Rodriguez-Serrano More articles by this author David Lopez More articles by this author Armando Stabile More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Camille Lanz More articles by this author Eric Barret More articles by this author François Rozet More articles by this author Petr Macek More articles by this author Xavier Cathelineau More articles by this author Lara Rodriguez-Sanchez More articles by this author Expand All Advertisement PDF downloadLoading ...