Imperial College London
Portrait Picture

Professor Hashim Ahmed

Faculty of Medicine, Department of Surgery & Cancer

Chair in Urology (Clinical)
 
 
 
//

Contact

 

hashim.ahmed

 
 
//

Location

 

5L28Lab BlockCharing Cross Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Peters:2017:10.1016/j.urolonc.2017.08.022,
author = {Peters, M and Kanthabalan, A and Shah, TT and McCartan, N and Moore, CM and Arya, M and van, der Voort van Zyp JR and Moerland, MA and Hindley, RG and Emberton, M and Ahmed, HU},
doi = {10.1016/j.urolonc.2017.08.022},
journal = {Urologic Oncology: Seminars and Original Investigations},
pages = {13.e1--13.e10},
title = {Development and internal validation of prediction models for biochemical failure and composite failure after focal salvage high intensity focused ultrasound for local radiorecurrent prostate cancer: Presentation of risk scores for individual patient prognoses.},
url = {http://dx.doi.org/10.1016/j.urolonc.2017.08.022},
volume = {36},
year = {2017}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - PURPOSE: Patient selection for focal salvage remains difficult. Therefore, we developed and internally validated prediction models for biochemical failure (BF) and a composite endpoint (CE) following focal salvage high intensity focused ultrasound (HIFU) for radiorecurrent prostate cancer. MATERIALS AND METHODS: A prospective HIFU registry identified 150 cases (November 2006-August 2015). Recurrence was assessed with multiparametric magnetic resonance imaging (MRI) combined with template prostate mapping biopsies, targeted biopsies, or systematic transrectal ultrasound-guided biopsies. Metastatic disease was ruled out with a positron emission tomography-computed tomography and a bone scan. Focal salvage HIFU consisted of quadrant-ablation, hemi-ablation, or index-lesion ablation. Cox-regression was used for BF (Phoenix-definition) and CE (BF/MRI+/biopsies+/local or systemic treatment/metastases+/prostate cancer specific mortality+). Internal validation was performed using bootstrap resampling (500 datasets) after which C-statistic and hazard ratios were adjusted. Models were calibrated and risk scores created. RESULTS: Median follow-up was 35 months (interquartile range: 22-52). Median biochemical disease-free survival (DFS) was 33 months (95% CI: 23-45). Median CE-free survival was 24 months (95% CI: 21-35). After multivariable analysis, DFS interval after primary radiotherapy, presalvage prostate-specific antigen (PSA), PSA-doubling time, prostatic volume, and T-stage (both MRI based) predicted BF. For the CE, PSA-doubling time was not predictive but additionally, primary Gleason score was. The adjusted C-statistics were 0.68 and 0.64 for BF and CE, respectively. Calibration was accurate until 48 months. The risk scores showed 3 groups, with biochemical DFS of 60%, 35%, and 7% and CE-free survival of 40%, 24%, and 0% at 4 years. CONCLUSION: Our model, once externally validated, could allow for better selection of patients for focal salvage HIFU.
AU  - Peters,M
AU  - Kanthabalan,A
AU  - Shah,TT
AU  - McCartan,N
AU  - Moore,CM
AU  - Arya,M
AU  - van,der Voort van Zyp JR
AU  - Moerland,MA
AU  - Hindley,RG
AU  - Emberton,M
AU  - Ahmed,HU
DO  - 10.1016/j.urolonc.2017.08.022
EP  - 1
PY  - 2017///
SN  - 1078-1439
SP  - 13
TI  - Development and internal validation of prediction models for biochemical failure and composite failure after focal salvage high intensity focused ultrasound for local radiorecurrent prostate cancer: Presentation of risk scores for individual patient prognoses.
T2  - Urologic Oncology: Seminars and Original Investigations
UR  - http://dx.doi.org/10.1016/j.urolonc.2017.08.022
UR  - http://hdl.handle.net/10044/1/51712
VL  - 36
ER  -
Download