Abstract:
INTRODUCTION:Focal therapy (FT) ablates areas of prostate cancer rather than treating the whole gland. We compared oncological outcomes of FT to radical prostatectomy (RP). METHODS:Using prospective multicentre databases of 761 FT and 572 RP cases (November/2005-September/2018), patients with PSA < 20 ng/ml, Gleason = 4 + 3 and stage = T2c were 1-1 propensity score-matched for treatment year, age, PSA, Gleason, T-stage, cancer core length and use of neoadjuvant hormones. FT included 1-2 sessions. Primary outcome was failure-free survival (FFS) defined by need for salvage local or systemic therapy or metastases. Differences in FFS were determined using Kaplan-Meier analysis with log-rank test. RESULTS:335 radical prostatectomy and 501 focal therapy patients were eligible for matching. For focal therapy, 420 had HIFU and 81 cryotherapy. Cryotherapy was used predominantly for anterior cancer. After matching, 246 RP and 246 FT cases were identified. For radical prostatectomy, mean (SD) age was 63.4 (5.6) years, median (IQR) PSA 7.9 g/ml (6-10) and median (IQR) follow-up 64 (30-89) months. For focal therapy, these were 63.3 (6.9) years, 7.9 ng/ml (5.5-10.6) and 49 [34-67] months, respectively. At 3, 5 and 8 years, FFS (95%CI) was 86% (81-91%), 82% (77-88%) and 79% (73-86%) for radical prostatectomy compared to 91% (87-95%), 86% (81-92%) and 83% (76-90%) following focal therapy (p = 0.12). CONCLUSIONS:In patients with non-metastatic low- intermediate prostate cancer, oncological outcomes over 8 years were similar between focal therapy and radical prostatectomy.
journal_name
Prostate Cancer Prostatic Disjournal_title
Prostate cancer and prostatic diseasesauthors
Shah TT,Reddy D,Peters M,Ball D,Kim NH,Gomez EG,Miah S,Evans DE,Guillaumier S,van Rossum PSN,Van Son MJ,Hosking-Jervis F,Dudderidge T,Hindley R,Emara A,McCracken S,Greene D,Nigam R,McCartan N,Valerio M,Minhas S,doi
10.1038/s41391-020-00315-ysubject
Has Abstractpub_date
2021-01-28 00:00:00eissn
1365-7852issn
1476-5608pii
10.1038/s41391-020-00315-ypub_type
杂志文章abstract::As high grade PIN is commonly associated with concomitant cancer, current literature recommends re-biopsy of patients with high grade PIN. This paper describes the prevalence of high grade prostatic intra-epithelial neoplasia (PIN) from three independent clinical settings, reported by a single pathologist (MCP). High ...
journal_title:Prostate cancer and prostatic diseases
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journal_title:Prostate cancer and prostatic diseases
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journal_title:Prostate cancer and prostatic diseases
pub_type: 杂志文章,meta分析
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journal_title:Prostate cancer and prostatic diseases
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Prostate cancer and prostatic diseases
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journal_title:Prostate cancer and prostatic diseases
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journal_title:Prostate cancer and prostatic diseases
pub_type: 临床试验,杂志文章
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