Imperial College London
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Professor Hashim Ahmed

Faculty of Medicine, Department of Surgery & Cancer

Chair in Urology (Clinical)
 
 
 
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Contact

 

hashim.ahmed

 
 
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Location

 

5L28Lab BlockCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Guillaumier:2018:10.1016/j.eururo.2018.06.006,
author = {Guillaumier, S and Peters, M and Arya, M and Afzal, N and Charman, S and Dudderidge, T and Hosking-Jervis, F and Hindley, RG and Lewi, H and McCartan, N and Moore, CM and Nigam, R and Ogden, C and Persad, R and Shah, K and van, der Meulen J and Virdi, J and Winkler, M and Emberton, M and Ahmed, HU},
doi = {10.1016/j.eururo.2018.06.006},
journal = {European Urology},
pages = {422--429},
title = {A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer},
url = {http://dx.doi.org/10.1016/j.eururo.2018.06.006},
volume = {74},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: Clinically significant non-metastatic prostate cancer is currently treated with whole-gland therapy. These are effective but can cause urinary, sexual and rectal side-effects. Objective: To report on 5-year prostate cancer control following focal high intensity focused ultrasound (HIFU) therapy to treat individual areas of cancer within the prostate.Design: Prospective study of consecutive patients who underwent focal therapy using HIFU (Sonablate) (1st/January/2006-31st/December/2015). Setting: Secondary care centres.Participants: 625 consecutive patients with non-metastatic clinically significant prostate cancer undergoing focal HIFU, of whom 599 had minimum 6 months follow-up. 505 (84%) had intermediate or high-risk prostate cancer.Interventions: Disease was localised using multi-parametric MRI, combined with targeted and systematic biopsies, or transperineal mapping biopsies. Areas of significant disease were treated. Follow-up included PSA, mpMRI and biopsies.Outcome Measurements and Statistical Analysis: The primary endpoint, failure-free survival (FFS), was defined as freedom from radical or systemic therapy, metastases and cancer-specific mortality.Results and Limitations: Median follow-up was 56 months (35-70). Median age was 65 years (IQR 61-71) and median pre-operative PSA 7.2ng/ml (IQR 5.2-10.0). FFS (95%CI) at 1, 3 and 5 years was 99% (98-100), 92% (90-95) and 88% (85-91). For low, intermediate and high-risk patients, metastasis-free, cancer-specific and overall survival at 5-years was 98% (97-99), 100% and 99% (97-100), respectively. In those patients returning validated questionnaires, 241/247 (98%) achieved complete pad-free urinary continence and none required more than one pad per day. Limitation includes lack of long-term follow-up.Conclusions: Focal therapy for select patients with clinically significant non-metastatic prostate cancer is effective in the medium term and has low probabilities of side-effects. Patient summary: In this m
AU  - Guillaumier,S
AU  - Peters,M
AU  - Arya,M
AU  - Afzal,N
AU  - Charman,S
AU  - Dudderidge,T
AU  - Hosking-Jervis,F
AU  - Hindley,RG
AU  - Lewi,H
AU  - McCartan,N
AU  - Moore,CM
AU  - Nigam,R
AU  - Ogden,C
AU  - Persad,R
AU  - Shah,K
AU  - van,der Meulen J
AU  - Virdi,J
AU  - Winkler,M
AU  - Emberton,M
AU  - Ahmed,HU
DO  - 10.1016/j.eururo.2018.06.006
EP  - 429
PY  - 2018///
SN  - 0302-2838
SP  - 422
TI  - A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer
T2  - European Urology
UR  - http://dx.doi.org/10.1016/j.eururo.2018.06.006
UR  - https://www.sciencedirect.com/science/article/pii/S0302283818304317?via%3Dihub
UR  - http://hdl.handle.net/10044/1/60631
VL  - 74
ER  -
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