Attention: Restrictions on use of AUA, AUAER, and UCF content in third party applications, including artificial intelligence technologies, such as large language models and generative AI.
You are prohibited from using or uploading content you accessed through this website into external applications, bots, software, or websites, including those using artificial intelligence technologies and infrastructure, including deep learning, machine learning and large language models and generative AI.
JU INSIGHT Outcomes Following Focal Ablative Therapy for Localized Clinically Significant Prostate Cancer in Patients >70 Years
By: David Habashy, University Hospital Southampton NHS Trust, United Kingdom, Deepika Reddy, Imperial Prostate, Imperial College London, United Kingdom, Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, Max Peters, University Medical Centre, Utrecht, The Netherlands, Taimur T. Shah, Imperial Prostate, Imperial College London, United Kingdom, Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, Marieke van Son, University Medical Centre, Utrecht, The Netherlands, Peter S. N. van Rossum, University Medical Centre, Utrecht, The Netherlands, Mariana Bertoncelli Tanaka, Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, Emma Cullen, Imperial Prostate, Imperial College London, United Kingdom, Ryan Engle, Imperial Prostate, Imperial College London, United Kingdom, Stuart McCracken, Sunderland Royal Hospital, City Hospital Foundation Trust, United Kingdom, Damian Greene, Spire Hospital, Washington, United Kingdom, Richard G. Hindley, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, United Kingdom, BMI The Hampshire Clinic, Basingstoke, United Kingdom, Amr Emara, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, United Kingdom, Ain Shams University Hospitals, Cairo, Egypt, Raj Nigam, Ain Shams University Hospitals, Cairo, Egypt, BMI Mount Alvernia Hospital, Guildford, United Kingdom, Clement Orczyk, University College London and University College Hospital London, United Kingdom, Iqbal Shergill, Wrexham Maelor Hospital, United Kingdom, Raj Persad, North Bristol NHS Trust, Westbury on Trym, United Kingdom, Jaspal Virdi, The Princess Alexandra Hospital NHS Trust, Harlow, United Kingdom, Caroline M. Moore, University College London and University College Hospital London, United Kingdom, Princess Grace Hospital, London, United Kingdom, King Edward VII Hospital, London, United Kingdom, Manit Arya, Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, University College London and University College Hospital London, United Kingdom, Mathias Winkler, Imperial Prostate, Imperial College London, United Kingdom, Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, Mark Emberton, University College London and University College Hospital London, United Kingdom, Princess Grace Hospital, London, United Kingdom, King Edward VII Hospital, London, United Kingdom, Hashim U. Ahmed, Imperial Prostate, Imperial College London, United Kingdom, Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom, King Edward VII Hospital, London, United Kingdom, Cromwell Hospital, London, United Kingdom, Tim Dudderidge, University Hospital Southampton NHS Trust, United Kingdom | Posted on: 20 Jul 2023
Habashy D, Reddy D, Peters M, et al. Evaluation of outcomes following focal ablative therapy for treatment of localized clinically significant prostate cancer in patients >70 years: a multi-institute, multi-energy 15-year experience. J Urol. 2023; 210(1):108-116.
Study Need and Importance
Knowing how best to manage the older comorbid patient with clinically significant prostate cancer can be challenging. Currently, the choice is often between radical treatment or watchful waiting. Could focal therapy represent an acceptable middle ground in those men in whom the above decision can be difficult to make?
What We Found
In a group of patients aged 70 years and over with primarily intermediate- and high-risk disease treated with focal therapy (FT), the 5-year overall survival was 96%, failure-free survival 82%, and the androgen deprivation therapy (ADT)–free survival 88%. The 5-year failure-free survival was 14% lower in the FT group when compared to a group of patients treated primarily with radiotherapy and its associated use of ADT. The burden of treatment associated with FT was lower than perhaps initially expected and felt to represent an acceptable treatment burden for the older or comorbid patient. On average, a patient can be expected to have 1 repeat MRI, and 1 in 3 patients expected to have a repeat biopsy.
Limitations
Limitations included relatively short median follow-up time of 24 months (IQR: 12, 41). The question of whether FT can prevent or delay the development of metastases or the need for ADT still needs to be tested in a direct comparison with watchful waiting.
Interpretation for Patient Care
FT may represent an acceptable middle ground for the older or comorbid patient with intermediate- or high-risk disease while potentially reducing the burden associated with palliative systemic therapy. A direct comparison between FT and watchful waiting would be invaluable.
advertisement
advertisement