Publications
568 results found
Shah TT, Kanthabalan A, Otieno M, et al., 2023, Corrigendum to "Magnetic Resonance Imaging and targeted biopsies compared to transperineal mapping biopsies prior to salvage focal therapy/ablation in localised and metastatic recurrent prostate cancer after radiotherapy. Primary Outcomes from the FORECAST Trial" [Eur Urol 2022;81(6):598-605]., Eur Urol, Vol: 83, Pages: e117-e118
Morote J, Pye H, Campistol M, et al., 2023, Accurate diagnosis of prostate cancer by combining Proclarix with magnetic resonance imaging., BJU Int
OBJECTIVES: The use of mpMRI has been a significant advance in the diagnosis of clinically significant prostate cancer (ISUP Grade Group ≥2, csPCa) and is recommended in most current guidelines. Proclarix® is a novel CE-marked biomarker test aiding in the identification of csPCa. The aim of the study was the assessment of the clinical performance of Proclarix alone or in combination with mpMRI to predict csPCa. PATIENTS AND METHODS: The study included blood samples from 721 men undergoing mpMRI followed by biopsy at University College London (UCL), London, and Vall d'Hebron University Hospital, Barcelona. Samples were tested blindly. The Proclarix-MRI model combining prostate volume, Proclarix and mpMRI results was trained using the UCL cohort (n=159) and validated in the Vall d'Hebron cohort (n=562). Its diagnostic performance was established in correlation to biopsy outcome and compared to available clinical parameters and risk calculators. RESULTS: Clinical performance of the Proclarix-MRI model in the validation cohort did not significantly differ from the training cohort and resulted in a sensitivity for csPCa of 90%, 90% NPV and 66% PPV. The Proclarix-MRI score's specificity (68%) was significantly (p<0.001) better compared to MRI-ERSPC risk score (51%), Proclarix (27%) or mpMRI (28%) alone. In addition, Proclarix by itself was found to be useful in the MRI PI-RADS 3 subgroup by outperforming PSA density in terms of specificity (25% vs 13%, p=0.004) at 100% sensitivity. CONCLUSION: When combined with mpMRI and prostate volume, Proclarix reliably predicted csPCa and ruled out men with no or indolent cancer. A large reduction of two thirds of unneeded biopsies was achieved. Proclarix can further be used with high confidence to reliably detect csPCa in men with an indeterminate PI-RADS 3 mpMRI. Despite these encouraging results, further validation is needed.
Pchejetski D, Hunter E, Dezfouli M, et al., 2023, Circulating Chromosome Conformation Signatures Significantly Enhance PSA Positive Predicting Value and Overall Accuracy for Prostate Cancer Detection, CANCERS, Vol: 15
Rakauskas A, Peters M, Ball D, et al., 2023, The impact of local staging of prostate cancer determined on MRI or DRE at time of radical prostatectomy on progression-free survival: A Will Rogers phenomenon., Urol Oncol, Vol: 41, Pages: 106.e9-106.e16
INTRODUCTION: We aimed to test whether the current practice of using mpMRI stage might lead to a Will Rogers phenomenon with a stage migration compared to DRE in men undergoing radical prostatectomy. MATERIAL AND METHODS: A total of 572 consecutive patients who underwent radical prostatectomy at a single institution (2007-2017) were included. Clinical stage using digital rectal examination was determined on table by the operating surgeon; mpMRI and pathological stage were recorded after tumor board review. Progression-free survival (PFS) was defined as no rising PSA, no adjuvant/salvage treatment, and no metastases or mortality. PFS was compared between groups and a model incorporating mpMRI into the EAU risk groups was created. RESULTS: Median age was 63 years (IQR 58.5-67) and median PSA was 8.9 ng/ml (IQR 6.5-13.2). Using DRE stage, 20% were NCCN low risk, 43% were intermediate, and 37% high. Median follow-up was 48 months (IQR 22-73). Estimated PFS at 1, 3, and 5 years was 75%, 59%, and 54%, respectively. When comparing PFS between DRE and mpMRI stages, patients deemed T1 (P < 0.01) or T3 (P = 0.03) by mpMRI showed better outcomes than patients staged T1 or T3 by DRE. On univariable analysis lower risk for failure was seen for MRI T1 disease (HR 0.10 95%, CI 0.01-0.73, P = 0.02) or MRI T3 (HR 0.70, CI 0.51-0.97, P = 0.03). On multivariable analysis, only MRI T1 remained a significant predictor (HR 0.08, 95% CI 0.01-0.59, P = 0.01). The subsequent, modified EAU risk model using both DRE and mpMRI performed significantly better than the DRE model. CONCLUSION: PFS based on mpMRI is not the same as DRE staging. Current risk groups which use DRE should be used with caution in whom local stage is based on mpMRI. Our modified EAU-risk categories can provide greater accuracy.
Merriel SW, Seggie A, Ahmed H, 2023, Diagnosis of prostate cancer in primary care: navigating updated clinical guidance., Br J Gen Pract, Vol: 73, Pages: 54-55
Connor MJJ, Gorin MAA, Eldred-Evans D, et al., 2023, Landmarks in the evolution of prostate biopsy, NATURE REVIEWS UROLOGY, ISSN: 1759-4812
Stavrinides V, Norris JM, Karapanagiotis S, et al., 2022, Regional Histopathology and Prostate MRI Positivity: A Secondary Analysis of the PROMIS Trial., Radiology
Background The effects of regional histopathologic changes on prostate MRI scans have not been accurately quantified in men with an elevated prostate-specific antigen (PSA) level and no previous biopsy. Purpose To assess how Gleason grade, maximum cancer core length (MCCL), inflammation, prostatic intraepithelial neoplasia (PIN), or atypical small acinar proliferation within a Barzell zone affects the odds of MRI visibility. Materials and Methods In this secondary analysis of the Prostate MRI Imaging Study (PROMIS; May 2012 to November 2015), consecutive participants who underwent multiparametric MRI followed by a combined biopsy, including 5-mm transperineal mapping (TPM), were evaluated. TPM pathologic findings were reported at the whole-prostate level and for each of 20 Barzell zones per prostate. An expert panel blinded to the pathologic findings reviewed MRI scans and declared which Barzell areas spanned Likert score 3-5 lesions. The relationship of Gleason grade and MCCL to zonal MRI outcome (visible vs nonvisible) was assessed using generalized linear mixed-effects models with random intercepts for individual participants. Inflammation, PIN, and atypical small acinar proliferation were similarly assessed in men who had negative TPM results. Results Overall, 161 men (median age, 62 years [IQR, 11 years]) were evaluated and 3179 Barzell zones were assigned MRI status. Compared with benign areas, the odds of MRI visibility were higher when a zone contained cancer with a Gleason score of 3+4 (odds ratio [OR], 3.1; 95% CI: 1.9, 4.9; P < .001) or Gleason score greater than or equal to 4+3 (OR, 8.7; 95% CI: 4.5, 17.0; P < .001). MCCL also determined visibility (OR, 1.24 per millimeter increase; 95% CI: 1.15, 1.33; P < .001), but odds were lower with each prostate volume doubling (OR, 0.7; 95% CI: 0.5, 0.9). In men who were TPM-negative, the presence of PIN increased the odds of zonal visibility (OR, 3.7; 95% CI: 1.5, 9.1; P = .004). Conclusion An incrementa
Bass EJJ, Ahmed HUU, 2022, Age-related PSA testing for prostate cancer: NICE recommendation 1.6.3, BJU INTERNATIONAL, Vol: 131, Pages: 130-131, ISSN: 1464-4096
Aydin A, Ahmed K, Abe T, et al., 2022, Effect of Simulation-based Training on Surgical Proficiency and Patient Outcomes: A Randomised Controlled Clinical and Educational Trial (vol 81, pg 385, 2022), EUROPEAN UROLOGY, Vol: 82, Pages: E179-E179, ISSN: 0302-2838
Eldred-Evans D, Connor MJ, Tanaka MB, et al., 2022, The rapid assessment for prostate imaging and diagnosis (RAPID) prostate cancer diagnostic pathway, BJU INTERNATIONAL, ISSN: 1464-4096
Peters M, Eldred-Evans D, Kurver P, et al., 2022, Predicting the Need for Biopsy to Detect Clinically Significant Prostate Cancer in Patients with a Magnetic Resonance Imaging- detected Prostate Imaging Reporting and Data System/Likert >3 Lesion: Development and Multinational External Validation of the Imperial Rapid Access to Prostate Imaging and Diagnosis Risk Score, EUROPEAN UROLOGY, Vol: 82, Pages: 559-568, ISSN: 0302-2838
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- Citations: 1
Bass E, Pantovic A, Connor M, et al., 2022, Diagnostic accuracy of magnetic resonance imaging targeted biopsy techniques compared to transrectal ultrasound guided biopsy of the prostate: a systematic review and meta-analysis, Prostate Cancer and Prostatic Diseases, Vol: 25, Pages: 174-179, ISSN: 1365-7852
BACKGROUND Multiparametric MRI localizes cancer in the prostate, allowing for MRI guided biopsy (MRI-GB) 43 alongside transrectal ultrasound guided systematic biopsy (TRUS-GB). Three MRI-GB approaches exist; visual estimation (COG-TB); fusion software-assisted (FUS-TB) and MRI ‘in-bore’ biopsy (IB-TB). It is unknown whether any of these are superior. We conducted a systematic review and meta-analysis to address 3 questions. First, whether MRI-GB is superior to TRUS-GB at detecting clinically significant PCa (csPCa). Second, whether MRI-GB is superior to TRUS-GB at avoiding detection of insignificant PCa. Third, whether any MRI-GB strategy is superior at detecting csPCa.METHODS A systematic literature review from 2015 to 2019 was performed in accordance with the START recommendations. Studies reporting PCa detection rates, employing MRI-GB and TRUS-GB were included and evaluated using the QUADAS-2 checklist. 1553 studies were found, of which 43 were included in the meta-analysis. RESULTS For csPCa, MRI-GB was superior in detection to TRUS-GB (0.83 vs. 0.63 [p=0.02]). MRI-GB was superior in detection to TRUS-GB at avoiding detection of insignificant PCa. No MRI-GB technique was superior at detecting csPCa (IB-TB 0.87; COG TB 0.81; FUS-TB 0.81,[p=0.55]). There was significant heterogeneity observed between the included studies. CONCLUSIONS In patients with suspected PCa on MRI, MRI-GB offers superior rates of csPCa detection and reduces detection of insignificant PCa compared to TRUS-GB. No individual MRI-GB technique was found to be better in csPCa detection. Prospective adequately powered randomized controlled trials are required.
Reddy D, Ahmed HU, 2022, Reply to Francesco Montorsi, Armando Stabile, Elio Mazzone, Giorgio Gandaglia, and Alberto Briganti's Letter to the Editor re: Deepika Reddy, Max Peters, Taimur T. Shah, et al. Cancer Control Outcomes Following Focal Therapy Using High-intensity Focused Ultrasound in 1379 Men with Nonmetastatic Prostate Cancer: A Multiinstitute 15-year Experience. Eur Urol 2022;81:407-13, EUROPEAN UROLOGY, Vol: 82, Pages: E74-E75, ISSN: 0302-2838
Eldred-Evans D, Burak P, Klimowska-Nassar N, et al., 2022, Direct mail from primary care and targeted recruitment strategies achieved a representative uptake of prostate cancer screening, JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 149, Pages: 98-109, ISSN: 0895-4356
Aydin A, Ahmed K, Raison N, et al., 2022, 671 The Effect of Supplementary Simulation-Based Procedural Training: The SIMULATE Randomised Controlled Clinical and Educational Trial, ASiT Surgical Conference, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Grey ADR, Scott R, Shah B, et al., 2022, Re: Multiparametric Ultrasound versus Multiparametric MRI to Diagnose Prostate Cancer (CADMUS): A Prospective, Multicentre, Paired-Cohort, Confirmatory Study Editorial Comment, JOURNAL OF UROLOGY, Vol: 208, Pages: 476-477, ISSN: 0022-5347
Merriel S, Archer S, Forster A, et al., 2022, Experiences of ‘traditional’ and ‘one-stop’ MRI-based prostate cancer diagnostic pathways in England: a qualitative study with patients and GPs, BMJ Open, ISSN: 2044-6055
Light A, Ahmed HU, Shah TT, 2022, The unclear role of PET-CT in localized radiorecurrent prostate cancer COMMENT, NATURE REVIEWS UROLOGY, Vol: 19, Pages: 573-574, ISSN: 1759-4812
Brunckhorst O, Liszka J, James C, et al., 2022, O035 Evaluating the mental wellbeing of prostate cancer patients: initial results from the ongoing MIND-P cohort study, Annual Scientific Meeting of the Surgical-Research-Society, Publisher: OXFORD UNIV PRESS, ISSN: 0007-1323
Brazao ES, Ahmed HU, 2022, Liquid Markers Should Precede Imaging in Pre-prostate Biopsy Decision-making: Con., Eur Urol Focus, Vol: 8, Pages: 895-896
Liquid biomarkers have not yet reached the level of evidence to replace magnetic resonance imaging in the prebiopsy pathway for prostate cancer.
Chiu PKF, Ahmed HU, Rastinehad AR, 2022, TRUS Biopsy vs Transperineal Biopsy for Suspicion of Prostate Cancer, UROLOGY, Vol: 164, Pages: 18-20, ISSN: 0090-4295
Reddy D, Dudderidge T, Shah T, et al., 2022, Comparative healthcare research outcomes of novel Surgery in prostate cancer (IP4-CHRONOS): Pilot RCT assessing feasibility of randomization for focal therapy in localized prostate cancer., Publisher: LIPPINCOTT WILLIAMS & WILKINS, ISSN: 0732-183X
Shah TT, Kanthabalan A, Otieno M, et al., 2022, Magnetic Resonance Imaging and Targeted Biopsies Compared to Transperineal Mapping Biopsies Before Focal Ablation in Localised and Metastatic Recurrent Prostate Cancer After Radiotherapy, EUROPEAN UROLOGY, Vol: 81, Pages: 598-605, ISSN: 0302-2838
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- Citations: 3
Peters M, Eldred-Evans D, Kurver P, et al., 2022, DERIVATION AND EXTERNAL VALIDATION OF A RAPID RISK SCORE FOR PREDICTING CLINICALLY SIGNIFICANT PROSTATE CANCER IN MEN WITH AN MRI VISIBLE LESION: A MULTINATIONAL COHORT STUDY, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E336-E336, ISSN: 0022-5347
Jaipuria J, Ahmed HU, 2022, Clinical and pathologic characteristics to select patients for focal therapy or partial gland ablation of nonmetastatic prostate cancer, CURRENT OPINION IN UROLOGY, Vol: 32, Pages: 224-230, ISSN: 0963-0643
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Peters M, Eldred-Evans D, Connor MJ, et al., 2022, Derivation and external validation of a RAPID Risk score for predicting significant prostate cancer, Publisher: ELSEVIER IRELAND LTD, Pages: S360-S361, ISSN: 0167-8140
Reddy D, Peters M, Shah T, et al., 2022, CANCER CONTROL OUTCOMES FOLLOWING FOCAL THERAPY USING HIFU IN 1,379 MEN WITH NON-METASTATIC PROSTATE CANCER: A MULTI-INSTITUTE 15-YEAR EXPERIENCE, Annual Meeting of the American-Urological-Association (AUA), Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E936-E936, ISSN: 0022-5347
Mondal S, Edwards S, Wibowo E, et al., 2022, Evaluating patterns and factors related to sleep disturbances in prostate cancer patients, Healthcare, Vol: 10, Pages: 1-12, ISSN: 2227-9032
Prostate cancer patients may experience disturbed sleep as a result of their diagnosis or treatment. This study sought to evaluate disturbed sleep and excessive daytime sleepiness in newly diagnosed patients and those receiving androgen deprivation therapy (ADT). This study was conducted with 74 patients. Subjective data using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) and actigraphy data on ADT/ADT-naïve patients were collected. The prevalence of poor sleep quality, determined from PSQI and ESS scores, was 50% and 16.7% respectively. Those on ADT (n = 20) had poorer sleep quality as determined by significantly higher PSQI scores (70 vs. 40% scoring > 5) and were more likely to have poor sleep quality, sleep latency, and sleep efficiency than ADT-naïve patients (n = 40). Actigraphy data showed that ADT patients slept significantly longer (7.7 vs. 6.8 h), experienced a higher Fragmentation Index (48.3 vs. 37.4%), and had longer daytime nap duration (64.1 vs. 45.2 min) than ADT-naïve patients. The use of objective measures such as actigraphy in the clinical arena is recommended and may be used as a valuable tool for research into sleep assessment in prostate cancer patients.
Reddy D, Peters M, Shah T, et al., 2022, FOCAL ABLATIVE SALVAGE THERAPY FOR RADIO-RECURRENT PROSTATE CANCER: 6 YEAR ONCOLOGICAL AND SAFETY OUTCOMES, Publisher: LIPPINCOTT WILLIAMS & WILKINS, Pages: E938-E939, ISSN: 0022-5347
Day E, Eldred-Evans D, Prevost AT, et al., 2022, Adjusting for verification bias in diagnostic accuracy measures when comparing multiple screening 2 tests - an application to the IP1-PROSTAGRAM study, BMC Medical Research Methodology, Vol: 22, ISSN: 1471-2288
Introduction Novel screening tests used to detect a target condition are compared against either a reference standard or other existing screening methods. However, as it is not always possible to apply the reference standard on the whole population under study, verification bias is introduced. Statistical methods exist to adjust estimates to account for this bias. We extend common methods to adjust for verification bias when multiple tests are compared to a reference standard using data from a prospective double blind screening study for prostate cancer. Methods Begg and Greenes method and multiple imputation are extended to include the results of multiple screening tests which determine condition verification status. These two methods are compared to the complete case analysis using the IP1-PROSTAGRAM study data. IP1-PROSTAGRAM used a paired84 cohort double-blind design to evaluate the use of imaging as alternative tests to screen for prostate85 cancer, compared to a blood test called prostate specific antigen (PSA). Participants with positive imaging (index) and/or PSA (control) underwent a prostate biopsy (reference). Results When comparing complete case results to Begg and Greenes and methods of multiple imputation there is a statistically significant increase in the specificity estimates for all screening tests. Sensitivity estimates remained similar across the methods, with completely overlapping 95% confidence intervals. Negative predictive value (NPV) estimates were higher when adjusting for verification bias, compared to complete case analysis, even though the 95% confidence intervals overlap. Positive predictive value (PPV) estimates were similar across all methods. Conclusion Statistical methods are required to adjust for verification bias in accuracy estimates of screening tests. Expanding Begg and Greenes method to include multiple screening tests can be computationally intensive, hence multiple imputation is recommended, especially as it can be modifie
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