You have accessJournal of UrologyCME1 Apr 2023MP73-03 THE PROPORTION OF PATIENTS ELIGIBLE FOR FOCAL THERAPY OF NON-METASTATIC PROSTATE CANCER IN THE MODERN MRI-DIRECTED DIAGNOSTIC PATHWAY Deepika Reddy, David Eldred-Evans, Mathias Winkler, Taimur Shah, and Hashim Ahmed Deepika ReddyDeepika Reddy More articles by this author , David Eldred-EvansDavid Eldred-Evans More articles by this author , Mathias WinklerMathias Winkler More articles by this author , Taimur ShahTaimur Shah More articles by this author , and Hashim AhmedHashim Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Medium-term outcomes following focal therapy for non-metastatic prostate cancer demonstrate good cancer control. There is uncertainty about what proportion of patients might be eligible for focal therapy, given the shift to an upfront MRI in the diagnostic pathway. Using four large prospective studies (PICTURE, PROMIS, IP1-PROSTAGRAM and RAPIDOnline), we evaluated how many newly diagnosed patients might be suitable for focal therapy. METHODS: Suitability was determined in a stepwise nature according to the Delphi Consensus criteria on focal therapy: PSA≤20 ng/ml, ≤rT3aN0M0, Gleason Grade Group (GGG) ≤3, if highest (GGG) was 1 then cancer length must be ≥6 mm, and treatment pattern must intend to spare at least 1 neurovascular bundle. Each study obtained local or external Research and Ethics approval. RESULTS: 201/330 (61%) recruited into PICTURE were diagnosed with≤rT3aN0 prostate cancer with PSA≤20 ng/ml of whom 119/201 (59%) were deemed suitable for focal treatment. None would have D’Amico low risk disease, 105 (88%) and 14 (12%) would have D’Amico intermediate and high-risk disease, respectively. Within PROMIS 406/740 (55%) patients had≤rT3aN0 prostate cancer and PSA≤20 ng/ml. 196/406 (48%) were focal suitable. 4 (2%), 76 (39%) and 116 (59%) had low, intermediate, and high-risk. 534/2372 (23%) in RAPID were diagnosed with≤rT3aN0 disease and PSA≤20 ng/ml. 364/534 (68%) were focal suitable. 3 (1%), 296 (82%) and 65 (18%) had low, intermediate, and high-risk. 37/411 (9%) patients recruited to IP1-PROSTAGRAM had≤rT3aN0 disease with PSA<20 ng/ml. 17/37 (46%) were focal suitable. 2 (12%) and 15 (88%) had low and intermediate-risk disease. CONCLUSIONS: Independent of varying incidence of prostate cancer within each cohorts, once diagnosed with localised disease between 5 and 7 patients out of 10 were eligible for focal treatment. Source of Funding: n/a © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1035 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Deepika Reddy More articles by this author David Eldred-Evans More articles by this author Mathias Winkler More articles by this author Taimur Shah More articles by this author Hashim Ahmed More articles by this author Expand All Advertisement PDF downloadLoading ...