Publications
621 results found
Huber PM, Afzal N, Arya M, et al., 2021, Focal HIFU therapy for anterior compared to posterior prostate cancer lesions, WORLD JOURNAL OF UROLOGY, Vol: 39, Pages: 1115-1119, ISSN: 0724-4983
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- Citations: 16
Ezzat A, Sood H, Holt J, et al., 2021, COVID-19: Are the elderly prepared for virtual health care?, BMJ Health & Care Informatics, Vol: 28, Pages: 1-1, ISSN: 2632-1009
Eldred-Evans D, Burak P, Connor M, et al., 2021, Population-based prostate cancer screening with Magnetic Resonance Imaging or Ultrasonography: the IP1-PROSTAGRAM study, JAMA Oncology, Vol: 7, Pages: 395-402, ISSN: 2374-2445
Importance: Screening for prostate cancer using PSA-testing can lead to problems of under- and over-diagnosis. A short, non-contrast MRI or transrectal ultrasound might overcome these limitations. Objective: To compare the performance of PSA, MRI and ultrasound as screening tests for prostate cancer. Design, Setting and Participants: This prospective, population-based, blinded cohort study was conducted at seven primary care practices and two imaging centres in the UK. 2034 community based men aged 50-69 years invited for prostate cancer screening and 408 were consented. Interventions: All participants underwent screening with a PSA test, MRI (T2-weighted and diffusion) and ultrasound (b-mode and shearwave elastography).-The tests were independently interpreted without knowledge of other results. Both imaging tests were reported on a validated 5-point scale of suspicion. If any test was screen-positive, a systematic 12-core biopsy was performed. Additionalimage-fusion targeted biopsies were taken if the MRI or ultrasound was positive. Main Outcomes and Measures: The proportion of men with screen-positive MRI or ultrasound (defined as either score 3-5 or 4-5) or screen-positive PSA (defined as PSA≥3g/L). Key secondary outcomes were the number of clinically-significant and clinically-insignificant cancers detected if each test was used exclusively. Clinically-significant cancer was defined as any Gleason score≥3+4. Results: The proportion with a screen-positive MRI (score 3-5) was higher than the proportion with a screen-positive PSA (72/406, 17.7%[95%CI 14.3-21.8] vs. 40/406,9.9%[95%CI 7.3-13.2]; p<0.001). The proportion with a screen-positive ultrasound (score 3-5) was also higher than PSA (96/405, 23.7% [95%CI 19.8-28.1];p<0.001). For an imaging threshold of score 4-5, the proportion with a screen-positive MRI was similar to PSA (43/406, 10.6%[95%CI 7.9-13.2];p=0.71), as was the proportion with a screen-positive ultrasound (52/405, 12.8%[95%CI 9.9-16.5
O'Connor LP, Lebastchi AH, Horuz R, et al., 2021, Role of multiparametric prostate MRI in the management of prostate cancer, WORLD JOURNAL OF UROLOGY, Vol: 39, Pages: 651-659, ISSN: 0724-4983
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- Citations: 17
Shah TT, Peters M, Miah S, et al., 2021, Assessment of Return to Baseline Urinary and Sexual Function Following Primary Focal Cryotherapy for Nonmetastatic Prostate Cancer, EUROPEAN UROLOGY FOCUS, Vol: 7, Pages: 301-308
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- Citations: 6
Barrett T, Padhani AR, Patel A, et al., 2021, Certification in reporting multiparametric magnetic resonance imaging of the prostate: recommendations of a UK consensus meeting, BJU INTERNATIONAL, Vol: 127, Pages: 304-306, ISSN: 1464-4096
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- Citations: 29
Connor M, Shah T, Smigeielska K, et al., 2021, Additional Treatments to the Local tumour for metastatic prostate cancer - Assessment of Novel Treatment Algorithms (IP2-ATLANTA): Protocol for a multicentre, phase II randomised controlled trial, BMJ Open, Vol: 11, ISSN: 2044-6055
Introduction Survival in men diagnosed with de novo synchronous metastatic prostate cancer has increased following the use of upfront systemic treatment, using chemotherapy and other novel androgen receptor targeted agents, in addition to standard androgen deprivation therapy (ADT). Local cytoreductive and metastasis-directed interventions are hypothesised to confer additional survival benefit. In this setting, IP2-ATLANTA will explore progression-free survival (PFS) outcomes with the addition of sequential multimodal local and metastasis-directed treatments compared with standard care alone.Methods A phase II, prospective, multicentre, three-arm randomised controlled trial incorporating an embedded feasibility pilot. All men with new histologically diagnosed, hormone-sensitive, metastatic prostate cancer, within 4 months of commencing ADT and of performance status 0 to 2 are eligible. Patients will be randomised to Control (standard of care (SOC)) OR Intervention 1 (minimally invasive ablative therapy to prostate±pelvic lymph node dissection (PLND)) OR Intervention 2 (cytoreductive radical prostatectomy±PLND OR prostate radiotherapy±pelvic lymph node radiotherapy (PLNRT)). Metastatic burden will be prespecified using the Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease (CHAARTED) definition. Men with low burden disease in intervention arms are eligible for metastasis-directed therapy, in the form of stereotactic ablative body radiotherapy (SABR) or surgery. Standard systemic therapy will be administered in all arms with ADT±upfront systemic chemotherapy or androgen receptor agents. Patients will be followed-up for a minimum of 2 years. Primary outcome: PFS. Secondary outcomes include predictive factors for PFS and overall survival; urinary, sexual and rectal side effects. Embedded feasibility sample size is 80, with 918 patients required in the main phase II component. Study recru
Reddy D, Ahmed HU, 2021, Template Mapping Biopsies: An Overview of Technique and Results, Interventional Urology, Second Edition, Pages: 145-159, ISBN: 9783030735647
Gold standard investigation for prostate cancer includes clinical examination and histological confirmation of disease. Transperineal template mapping biopsies have high diagnostic accuracy, whilst providing specific disease localization, and anticipated tumour volume allowing for accurate risk stratification, whilst improving confirmation of disease absence when compared to traditional random transrectal ultrasound (TRUS) biopsy. Further, template mapping prostate biopsies allow for a systematic evaluation of all areas of the prostate and, therefore, are an ideal reference for validation studies.
Tam J, Ahmed H, 2021, Embryology, Anatomy, and Physiology of the Prostate, Basic Urological Sciences, Pages: 73-79, ISBN: 9780367250669
Noureldin M, Eldred-Evans D, Khoo CC, et al., 2021, Review article: MRI-targeted biopsies for prostate cancer diagnosis and management, WORLD JOURNAL OF UROLOGY, Vol: 39, Pages: 57-63, ISSN: 0724-4983
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- Citations: 11
Tanaka MB, St John ER, Exarchos G, et al., 2021, Safety and adverse events of urgent elective surgery during COVID-19 within three UK hospitals, BRITISH JOURNAL OF SURGERY, Vol: 108, Pages: E51-E52, ISSN: 0007-1323
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- Citations: 2
Stavrinides V, Syer T, Hu Y, et al., 2021, False Positive Multiparametric Magnetic Resonance Imaging Phenotypes in the Biopsy-naive Prostate: Are They Distinct from Significant Cancer-associated Lesions? Lessons from PROMIS, EUROPEAN UROLOGY, Vol: 79, Pages: 20-29, ISSN: 0302-2838
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- Citations: 12
Ahmed HU, Hindley RG, Kalpee A, et al., 2020, COST COMPARISON OF SURGICAL INTERVENTIONS TO TREAT LOWER URINARY TRACT SYMPTOMS (LUTS) SECONDARY TO BENIGN PROSTATIC HYPERPLASIA (BPH) IN THE UK, SWEDEN, AND SOUTH AFRICA, Publisher: ELSEVIER SCIENCE INC, Pages: S580-S580, ISSN: 1098-3015
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- Citations: 1
Stavrinides V, Mendes LT, Freeman A, et al., 2020, Inflammation burden in benign tissue is inversely associated with significant cancer burden in the prostate: lessons from the PROMIS study, Publisher: SPRINGER, Pages: S4-S4, ISSN: 0945-6317
Edison MA, Connor MJ, Miah S, et al., 2020, Understanding virtual urology clinics: a systematic review., BJU International, Vol: 126, Pages: 536-546, ISSN: 1464-4096
OBJECTIVE: To perform a systematic review to identify the clinical, fiscal and environmental evidence on the use of urological telehealth and/or virtual clinic strategies. Our secondary aim was to highlight research gaps in this rapidly evolving field. METHODS: Our PROSPERO registered (CRD42019151946) systematic search of Embase, Medline and Cochrane Review Database was performed for original research articles pertaining to adult urology telehealth or virtual clinic strategies. Risk of bias (RoB) assessment performed according to Cochrane 2.0 RoB or Joanna Briggs Institute Checklist for non-randomised studies. RESULTS: 5,813 participants met inclusion from 18 original articles (2 randomised controlled trials; 10 prospective; 6 retrospective). Urology sub-specialities: Uro-oncology (n=6), General urology (n=8), Endo-urology (n=2), and Lower urinary tract symptoms and/or incontinence (n=2). Across all sub-specialties, prospective studies utilising VC reported: primary median VC discharge rate of 16.6% (IQR 14.7%-29.8%) and primary median face-to-face (FTF) clinic referral rate of 32.4% (IQR 15.5%-53.3%). Further, direct cost analysis demonstrated a median annual cost-savings of £56,232 (IQR £46,260-£61,116). Grade II and IIIb complications were reported in two acute ureteric colic studies, with a rate of 0.20% (3/1,534) and 0.13% (2/1,534), respectively. Annual carbon footprint avoided ranged from 0.7 to 4.35 metric tonnes of CO2 emissions, depending on mode of transport utilised. Patient satisfaction was inconsistently reported, and assessments lacked prospective evaluation using validated questionnaires. CONCLUSION: Virtual urology clinics are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological subspecialties to confirm equivalency and safety against traditional face-to-face assessment.
Connor MJ, Dasgupta P, Ahmed HU, et al., 2020, Autonomous surgery in the era of robotic urology: friend or foe of the future surgeon?, NATURE REVIEWS UROLOGY, Vol: 17, Pages: 643-649, ISSN: 1759-4812
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- Citations: 12
Kanthabalan A, Arya M, Freeman A, et al., 2020, Intraprostatic Cancer Recurrence following Radical Radiotherapy on Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy, JOURNAL OF UROLOGY, Vol: 204, Pages: 950-954, ISSN: 0022-5347
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- Citations: 4
Paliashvili K, Popov A, Kalber TL, et al., 2020, Peritumoral delivery of docetaxel-TIPS microparticles for prostate cancer adjuvant therapy, Advanced Therapeutics, Vol: 4, Pages: 1-11, ISSN: 2366-3987
Recurrence of prostate cancer after radical prostatectomy is a consequence of incomplete tumor resection. Systemic chemotherapy after surgery is associated with significant toxicity. Improved delivery methods for toxic drugs capable of targeting positive resection margins can reduce tumor recurrence and avoid their known toxicity. This study evaluates the effectiveness and toxicity of docetaxel (DTX) release from highly porous biodegradable microparticles intended for delivery into the tissue cavity created during radical prostatectomy to target residual tumor cells. The microparticles, composed of poly(dl-lactide-co-glycolide) (PLGA), are processed using thermally induced phase separation (TIPS) and loaded with DTX via antisolvent precipitation. Sustained drug release and effective toxicity in vitro are observed against PC3 human prostate cells. Peritumoral injection in a PC3 xenograft tumor model results in tumor growth inhibition equivalent to that achieved with intravenous delivery of DTX. Unlike intravenous delivery of DTX, implantation of DTX-TIPS microparticles is not accompanied by toxicity or elevated systemic levels of DTX in organ tissues or plasma. DTX-TIPS microparticles provide localized and sustained release of nontoxic therapeutic amounts of DTX. This may offer novel therapeutic strategies for improving management of patients with clinically localized high-risk disease requiring radical prostatectomy and other solid cancers at high risk of positive resection margins.
Echeverria LMC, Haider A, Freeman A, et al., 2020, A critical evaluation of visual proportion of Gleason 4 and maximum cancer core length quantified by histopathologists, SCIENTIFIC REPORTS, Vol: 10, ISSN: 2045-2322
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- Citations: 4
Bosaily AE-S, Frangou E, Ahmed HU, et al., 2020, Additional Value of Dynamic Contrast-enhanced Sequences in Multiparametric Prostate Magnetic Resonance Imaging: Data from the PROMIS Study, EUROPEAN UROLOGY, Vol: 78, Pages: 503-511, ISSN: 0302-2838
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- Citations: 27
Connor M, Smith A, Saiful M, et al., 2020, Targeting oligometastasis with stereotactic ablative radiation therapy or surgery in metastatic hormone-sensitive prostate cancer: a systematic review of prospective clinical trials, European Urology Oncology, Vol: 3, Pages: 582-593, ISSN: 2588-9311
Context: Metastasis directed therapy (MDT) in the form of stereotactic ablative radiation therapy (SABR), or in combination with surgical metastasectomy, may have a role in cancer control and disease progression.Objective: To perform a systematic review of MDT (Surgery or SABR) for oligometastatic (up to 10 metastasis, recurrent or de novo) hormone-sensitive prostate cancer in addition or following primary prostate gland treatment. Evidence Acquisition: Medline, Embase, Cochrane Review Database and Clinical Trial Databases were systematically searched for clinical trials reporting oncological outcomes and safety. Risk-of-bias was assessed with Cochrane 2.0 tool or ROBINS-I.Evidence Synthesis: From 1,025 articles identified, 4 clinical trials met prespecified criteria. These included two randomised and two non-randomised clinical trials (n = 169). Baseline PSA-level, age and metastasis ranged from 2.0 – 17.0 ng/ml, 43 to 75 yrs and 1 to 7 lesions, respectively. Nodal, bone, nodal and bone, visceral metastases were present in 49.7% (84/169), 33.7% (57/169), 15.9% (27/169), and 0.5% (1/169), respectively. Diagnostic conventional imaging was used in 43.7% (74/169) and positron-emission-tomography/computerized tomography (PET/CT) in 56.2% (95/169). SABR and surgical metastasectomy with SABR was used in 78.3% (94/120), and 21.6% (26/120), respectively. Early progression-free survival (PFS) ranged from 19% to 60%. Local control (LC) was reported as 93% to 100%. Grade II and III SABR toxicity were reported in 8% (8/100) and 1% (1/100), respectively. Grade IIIa and IIIb surgical complications were reported in 7.69% (2/26) and 0% (0/26), respectively. Conclusion: MDT is a promising experimental therapeutic approach in men with hormone sensitive oligometastatic prostate cancer. Randomized comparative studies are required to ascertain role and optimal timing in oligometastatic recurrence and efficacy in de novo synchronous disease.
Jambor I, Falagario UG, Martini A, et al., 2020, Re: Antonio C. Westphalen, Charles E. McCulloch, Jordan M. Anaokar, et al. Variability of the Positive Predictive Value of PI-RADS for Prostate MRI across 26 Centers: Experience of the Society of Abdominal Radiology Prostate Cancer Disease-focused Panel. Radiology 2020;296:76-84 <i>Can the Positive Predictive Value of Prostate MRI in Correlation with Biopsy Findings be Interpreted Without Diving into Details</i>?, EUROPEAN UROLOGY ONCOLOGY, Vol: 3, Pages: 714-715
Sathianathen NJ, Omer A, Harriss E, et al., 2020, Negative Predictive Value of Multiparametric Magnetic Resonance Imaging in the Detection of Clinically Significant Prostate Cancer in the Prostate Imaging Reporting and Data System Era: A Systematic Review and Meta-analysis, EUROPEAN UROLOGY, Vol: 78, Pages: 402-414, ISSN: 0302-2838
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- Citations: 137
Eldred-Evans D, Tam H, Sokhi H, et al., 2020, Rethinking prostate cancer screening: could MRI be an alternative screening test?, NATURE REVIEWS UROLOGY, Vol: 17, Pages: 526-539, ISSN: 1759-4812
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- Citations: 15
Padhani AR, Villeirs G, Ahmed HU, et al., 2020, Platinum Opinion Counterview: The Evidence Base for the Benefit of Magnetic Resonance Imaging-directed Prostate Cancer Diagnosis is Sound, EUROPEAN UROLOGY, Vol: 78, Pages: 307-309, ISSN: 0302-2838
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- Citations: 5
Connor MJ, Winkler M, Ahmed HU, 2020, Cytoreductive cryotherapy for newly diagnosed oligometastatic hormone-sensitive prostate cancer, PROSTATE CANCER AND PROSTATIC DISEASES, Vol: 23, Pages: 537-538, ISSN: 1365-7852
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- Citations: 2
Simpson BS, Echeverria LMC, Norris JM, et al., 2020, Re: Gregory T. Chesnut, Emily A. Vertosick, Nicole Benfante, et al. Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance. Eur Urol 2020;77:501-7, EUROPEAN UROLOGY, Vol: 78, Pages: E106-E107, ISSN: 0302-2838
Eldred-Evans D, Tam H, Smith APT, et al., 2020, Use of imaging to optimise prostate cancer tumour volume assessment for focal therapy planning, Current Urology Reports, Vol: 21, Pages: 1-10, ISSN: 1527-2737
Purpose of ReviewRapid advances in imaging of the prostate have facilitated the development of focal therapy and provided a non-invasive method of estimating tumour volume. Focal therapy relies on an accurate estimate of tumour volume for patient selection and treatment planning so that the optimal energy dose can be delivered to the target area(s) of the prostate while minimising toxicity to surrounding structures. This review provides an overview of different imaging modalities which may be used to optimise tumour volume assessment and critically evaluates the published evidence for each modality.Recent FindingsMulti-parametric MRI (mp-MRI) has become the standard tool for patient selection and guiding focal therapy treatment. The current evidence suggests that mp-MRI may underestimate tumour volume, although there is a large variability in results. There remain significant methodological challenges associated with pathological processing and accurate co-registration of histopathological data with mp-MRI. Advances in different ultrasound modalities are showing promise but there has been limited research into tumour volume estimation. The role of PSMA PET/CT is still evolving and further investigation is needed to establish if this is a viable technique for prostate tumour volumetric assessment.Summarymp-MRI provides the necessary tumour volume information required for selecting patients and guiding focal therapy treatment. The potential for underestimation of tumour volume should be taken into account and an additional margin applied to ensure adequate treatment coverage. At present, there are no other viable image-based alternatives although advances in new technologies may refine volume estimations in the future.
Norris JM, Echeverria LMC, Bott SRJ, et al., 2020, What Type of Prostate Cancer Is Systematically Overlooked by Multiparametric Magnetic Resonance Imaging? An Analysis from the PROMIS Cohort, EUROPEAN UROLOGY, Vol: 78, Pages: 163-170, ISSN: 0302-2838
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- Citations: 50
Stabile A, Orczyk C, Giganti F, et al., 2020, The Role of Percentage of Prostate-specific Antigen Reduction After Focal Therapy Using High-intensity Focused Ultrasound for Primary Localised Prostate Cancer. Results from a Large Multi-institutional Series, EUROPEAN UROLOGY, Vol: 78, Pages: 155-160, ISSN: 0302-2838
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- Citations: 16
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