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{Shah:2016:10.1038/pcan.2016.23,
author = {Shah, TT and Peters, M and Kanthabalan, A and McCartan, N and Fatola, Y and van, Zyp JVDV and van, Vulpen M and Freeman, A and Moore, CM and Arya, M and Emberton, M and Ahmed, HU},
doi = {10.1038/pcan.2016.23},
journal = {Prostate Cancer and Prostatic Diseases},
pages = {311--316},
title = {PSA nadir as a predictive factor for biochemical disease-free survival and overall survival following whole-gland salvage HIFU following radiotherapy failure},
url = {http://dx.doi.org/10.1038/pcan.2016.23},
volume = {19},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Treatment options for radio-recurrent prostate cancer are either androgen-deprivation therapy or salvageprostatectomy. Whole-gland high-intensity focussed ultrasound (HIFU) might have a role in this setting.METHODS: An independent HIFU registry collated consecutive cases of HIFU. Between 2005 and 2012, we identified 50 men whounderwent whole-gland HIFU following histological confirmation of localised disease following prior external beam radiotherapy(2005–2012). No upper threshold was applied for risk category, PSA or Gleason grade either at presentation or at the time of failure.Progression was defined as a composite with biochemical failure (Phoenix criteria (PSA4nadir+2 ng ml − 1)), start of systemictherapies or metastases.RESULTS: Median age (interquartile range (IQR)), pretreatment PSA (IQR) and Gleason score (range) were 68 years (64–72),5.9 ng ml − 1 (2.2–11.3) and 7 (6–9), respectively. Median follow-up was 64 months (49–84). In all, 24/50 (48%) avoided androgendeprivationtherapies. Also, a total of 28/50 (56%) achieved a PSA nadir o0.5 ng ml − 1, 15/50 (30%) had a nadir  0.5 ng ml − 1 and7/50 (14%) did not nadir (PSA non-responders). Actuarial 1, 3 and 5-year progression-free survival (PFS) was 72, 40 and 31%,respectively. Actuarial 1, 3 and 5-year overall survival (OS) was 100, 94 and 87%, respectively. When comparing patients with PSAnadir o0.5 ng ml − 1, nadir 0.5 and non-responders, a statistically significant difference in PFS was seen (Po0.0001). Three-yearPFS in each group was 57, 20 and 0%, respectively. Five-year OS was 96, 100 and 38%, respectively. Early in the learning curve,between 2005 and 2007, 3/50 (6%) developed a fistula. Intervention for bladder outlet obstruction was needed in 27/50 (54%).Patient-reported outcome measure questionnaires showed incontinence (any pad-use) as 8/26 (31%).CONCLUSIONS: In our series of high-risk patients, in whom 30–50% may have mic
AU  - Shah,TT
AU  - Peters,M
AU  - Kanthabalan,A
AU  - McCartan,N
AU  - Fatola,Y
AU  - van,Zyp JVDV
AU  - van,Vulpen M
AU  - Freeman,A
AU  - Moore,CM
AU  - Arya,M
AU  - Emberton,M
AU  - Ahmed,HU
DO  - 10.1038/pcan.2016.23
EP  - 316
PY  - 2016///
SN  - 1365-7852
SP  - 311
TI  - PSA nadir as a predictive factor for biochemical disease-free survival and overall survival following whole-gland salvage HIFU following radiotherapy failure
T2  - Prostate Cancer and Prostatic Diseases
UR  - http://dx.doi.org/10.1038/pcan.2016.23
UR  - http://hdl.handle.net/10044/1/53564
VL  - 19
ER  -
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