MP70-12 PREDICTING EXTENSIVE DISEASE AMONG POTENTIAL CANDIDATES FOR HEMI-ABLATIVE FOCAL THERAPY FOR PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I1 Apr 2017MP70-12 PREDICTING EXTENSIVE DISEASE AMONG POTENTIAL CANDIDATES FOR HEMI-ABLATIVE FOCAL THERAPY FOR PROSTATE CANCER Toshikazu Takeda, Amy Tin, Renato Corradi, Maha Mamoor, Nicola Robertson, Hebert Vargas, Nicole Benfante, Daniel Sjoberg, Samson Fine, James Eastham, Peter Scardino, and Karim Touijer Toshikazu TakedaToshikazu Takeda More articles by this author , Amy TinAmy Tin More articles by this author , Renato CorradiRenato Corradi More articles by this author , Maha MamoorMaha Mamoor More articles by this author , Nicola RobertsonNicola Robertson More articles by this author , Hebert VargasHebert Vargas More articles by this author , Nicole BenfanteNicole Benfante More articles by this author , Daniel SjobergDaniel Sjoberg More articles by this author , Samson FineSamson Fine More articles by this author , James EasthamJames Eastham More articles by this author , Peter ScardinoPeter Scardino More articles by this author , and Karim TouijerKarim Touijer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2288AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although there is increasing interest in focal therapy for prostate cancer as an alternative treatment option to whole-gland therapy, it remains difficult to select eligible candidates. We sought to identify preoperative factors that can predict extensive disease after radical prostatectomy (RP) in potential candidates for hemi-ablative focal therapy. METHODS We identified 770 patients who were diagnosed with unilateral prostate cancer by biopsy, met the focal therapy consensus meeting criteria (PSA<15 ng/mL, clinical stage T1c-T2a, Gleason score 3+3 or 3+4), and had undergone RP at our institution between 2000 and 2014. Among these 770 patients, 98 had tumor maps from whole-mount slides and magnetic resonance imaging (MRI) data. Extensive disease was defined as having Gleason pattern 4 or 5 in bilateral lobes, extracapsular extension, seminal vesicle involvement, or lymph node involvement on the tumor map and RP pathology. Both lobes of the prostate were scored using the standardized 5-point Prostate Imaging Reporting and Data System version 2 on MRI. Extracapsular extension and seminal vesicle involvement were also scored using a 5-point scale. Preoperative characteristics including biopsy and MRI data were evaluated. Selected predictors of extensive disease were analyzed by multivariable logistic regression. Decision curve analysis was performed to evaluate the clinical utility of our model. RESULTS Among our cohort, 39 patients (40%; 95% CI 30%, 50%) had extensive disease. The Kattan nomogram score (p=0.020) and a MRI extracapsular extension score ≥3 (p=0.002) were independent predictors of extensive disease. Our model exhibited a discrimination of 0.698 after 10-fold cross-validation. However, decision curve analysis demonstrated that our multivariable model does not add value for threshold probabilities of having extensive disease below 20%, with no increase in net benefits compared to a treat-all strategy. CONCLUSIONS Although the variables in our model are significantly associated with extensive disease, it was not able to place patients into a low enough risk of extensive disease where hemi-ablative therapy would be indicated. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e939 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Toshikazu Takeda More articles by this author Amy Tin More articles by this author Renato Corradi More articles by this author Maha Mamoor More articles by this author Nicola Robertson More articles by this author Hebert Vargas More articles by this author Nicole Benfante More articles by this author Daniel Sjoberg More articles by this author Samson Fine More articles by this author James Eastham More articles by this author Peter Scardino More articles by this author Karim Touijer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...