You have accessJournal of UrologyProstate Cancer: Localized V1 Apr 20121134 PATTERNS OF PROSTATE CANCER ON TEMPLATE PROSTATE MAPPING BIOPSIES IN 291 MEN IMPLICATIONS FOR FOCAL THERAPY Hashim Ahmed, Paras Singh, Alex Freeman, Emma Dalton, Daniel Stevens, Omar Barbouti, and Mark Emberton Hashim AhmedHashim Ahmed London, United Kingdom More articles by this author , Paras SinghParas Singh London, United Kingdom More articles by this author , Alex FreemanAlex Freeman London, United Kingdom More articles by this author , Emma DaltonEmma Dalton London, United Kingdom More articles by this author , Daniel StevensDaniel Stevens Cardiff, United Kingdom More articles by this author , Omar BarboutiOmar Barbouti London, United Kingdom More articles by this author , and Mark EmbertonMark Emberton London, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1243AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Template Prostate Mapping (TPM) biopsies using a 5mm sampling frame is an accurate test that can localise clinically significant prostate cancer in order to aid focal therapy. Our aim was to describe the patterns of prostate cancer on TPM and as a result determine the proportion of men who may be suitable for tissue-preserving therapy. METHODS Men undergoing TPM with no prior therapy were identified. Criteria used to decide suitability for focal therapy were those used in prospective ethics-committee approved trials recruiting during the period of this study. Thus, 4 broad categories were used to reflect inclusion criteria for these trials. So, cancer had to be either, 1) unifocal - suitable for unifocal ablation; 2) unilateral - suitable for ablation of the entire lobe (hemiablation); 3) bilateral and bifocal in which at least one neurovascular bundle could be avoided - suitable for bilateral bifocal ablation; or 4) bilateral multifocal with one dominant lesion by volume/grade (index lesion) and secondary lesions with Gleason </=3+3 and maximum cancer core length involvement </=3mm - suitable for index lesion ablation. RESULTS 377 men underwent TPM between 05/2006 to 05/2010; of these, 291 had no previous treatment. 80% (233/291) had low or low-intermediate risk cancer on previous transrectal biopsy, 12% (34/291) had previous negative transrectal biopsy and 8% (24/291) had no prior biopsy. Mean age was 62 years (SD+/-7.4), mean PSA 7.6ng/ml (SD+/-4.5). 85% (199/233) of men had unilateral cancer on TRUS biopsy. A mean of 29 (SD+/-17) biopsies were taken at TPM with a mean of 5 (SD+/-5) positive biopsies. 12% (34/291) had no cancer on TPM and 14% (42/291) required radical therapy due to large volume bilateral multifocal disease and/or Gleason >4+3. Overall, 74% (215/291) were suitable for at least one form of focal therapeutic strategy. These included unifocal ablation in 18%, hemi-ablation in 24%, bilateral and bifocal ablation in 12% and index lesion ablation in 20%. CONCLUSIONS TPM is an accurates means by which disease can be localised for the purpose of focal therapy. When it isapplied to men seeking re-classification of their disease status, three-quarters were potentially eligible for a form of focal therapy currently undergoing evaluation within prospective clinical trials. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e459-e460 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hashim Ahmed London, United Kingdom More articles by this author Paras Singh London, United Kingdom More articles by this author Alex Freeman London, United Kingdom More articles by this author Emma Dalton London, United Kingdom More articles by this author Daniel Stevens Cardiff, United Kingdom More articles by this author Omar Barbouti London, United Kingdom More articles by this author Mark Emberton London, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...