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Intra-prostatic Cancer Recurrence following Radical Radiotherapy on Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy.
J Urol. 2020 Jun 30 [Online ahead of print]JU

Abstract

BACKGROUND

Men who fail external beam radiotherapy (EBRT) are usually placed on delayed hormone therapy. Some of these men have localised recurrence that might be suitable for further local therapy. We aimed to describe patterns of recurrence, and suitability for focal ablative therapy, in those undergoing transperineal template prostate-mapping (TTPM) biopsies.

METHOD

145 consecutive patients (December 2007-May 2014) referred with suspicion of recurrence due to rising PSA after EBRT or brachytherapy who underwent TTPM-biopsies. Suitability for focal ablative therapy required the cancer to be either unifocal or unilateral, or bilateral/multifocal with one dominant index lesion and secondary lesions with Gleason score 3+3=6 with no more than 3mm cancer core involvement.

RESULTS

The mean age was 70.7 (SD 5.8) years. Median PSA at time of TTPM-biopsy was 4.5 (IQR 2.5-7.7). Overall, 75.9% (110/145) were suitable for a form of focal salvage treatment; 40.7% (59/145) were suitable for quadrant ablation, 14.5% (21/145) hemiablation, 14.5% (21/145) bilateral focal ablation and 6.2% (9/145) for index lesion ablation.

CONCLUSION

Three quarters of patients who have localised radio-recurrent prostate cancer may be suitable for focal ablative therapy to the prostate based on transperineal template prostate mapping biopsies.

Authors+Show Affiliations

Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK. Department of Urology, UCLH NHS Foundation Trust, London, UK.Department of Urology, UCLH NHS Foundation Trust, London, UK.Department of Histopathology, UCLH NHS Foundation Trust, London, UK.Department of Clinical Oncology, UCLH NHS Foundation Trust, London, UK.Department of Clinical Oncology, UCLH NHS Foundation Trust, London, UK.Department of Radiation Oncology, University Medical Centre Utrecht, The Netherlands.Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK. Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK. Imperial Urology, Imperial College Healthcare NHS Trust, London, UK.Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK. Department of Urology, UCLH NHS Foundation Trust, London, UK.Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London, UK. Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK. Imperial Urology, Imperial College Healthcare NHS Trust, London, UK.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32602770

Citation

Kanthabalan, A, et al. "Intra-prostatic Cancer Recurrence Following Radical Radiotherapy On Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy." The Journal of Urology, 2020, pp. 101097JU0000000000001201.
Kanthabalan A, Arya M, Freeman A, et al. Intra-prostatic Cancer Recurrence following Radical Radiotherapy on Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy. J Urol. 2020.
Kanthabalan, A., Arya, M., Freeman, A., Mitra, A. V., Payne, H., Peters, M., Shah, T. T., Emberton, M., & Ahmed, H. U. (2020). Intra-prostatic Cancer Recurrence following Radical Radiotherapy on Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy. The Journal of Urology, 101097JU0000000000001201. https://doi.org/10.1097/JU.0000000000001201
Kanthabalan A, et al. Intra-prostatic Cancer Recurrence Following Radical Radiotherapy On Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy. J Urol. 2020 Jun 30;101097JU0000000000001201. PubMed PMID: 32602770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intra-prostatic Cancer Recurrence following Radical Radiotherapy on Transperineal Template Mapping Biopsy: Implications for Focal Ablative Salvage Therapy. AU - Kanthabalan,A, AU - Arya,M, AU - Freeman,A, AU - Mitra,A V, AU - Payne,H, AU - Peters,M, AU - Shah,T T, AU - Emberton,M, AU - Ahmed,H U, Y1 - 2020/06/30/ PY - 2020/7/1/entrez KW - focal salvage treatment KW - radiorecurrent prostate cancer KW - radiotherapy KW - transperineal prostate mapping biopsy SP - 101097JU0000000000001201 EP - 101097JU0000000000001201 JF - The Journal of urology JO - J. Urol. N2 - BACKGROUND: Men who fail external beam radiotherapy (EBRT) are usually placed on delayed hormone therapy. Some of these men have localised recurrence that might be suitable for further local therapy. We aimed to describe patterns of recurrence, and suitability for focal ablative therapy, in those undergoing transperineal template prostate-mapping (TTPM) biopsies. METHOD: 145 consecutive patients (December 2007-May 2014) referred with suspicion of recurrence due to rising PSA after EBRT or brachytherapy who underwent TTPM-biopsies. Suitability for focal ablative therapy required the cancer to be either unifocal or unilateral, or bilateral/multifocal with one dominant index lesion and secondary lesions with Gleason score 3+3=6 with no more than 3mm cancer core involvement. RESULTS: The mean age was 70.7 (SD 5.8) years. Median PSA at time of TTPM-biopsy was 4.5 (IQR 2.5-7.7). Overall, 75.9% (110/145) were suitable for a form of focal salvage treatment; 40.7% (59/145) were suitable for quadrant ablation, 14.5% (21/145) hemiablation, 14.5% (21/145) bilateral focal ablation and 6.2% (9/145) for index lesion ablation. CONCLUSION: Three quarters of patients who have localised radio-recurrent prostate cancer may be suitable for focal ablative therapy to the prostate based on transperineal template prostate mapping biopsies. SN - 1527-3792 UR - https://www.unboundmedicine.com/medline/citation/32602770/Intra-prostatic_Cancer_Recurrence_following_Radical_Radiotherapy_on_Transperineal_Template_Mapping_Biopsy:_Implications_for_Focal_Ablative_Salvage_Therapy L2 - https://www.jurology.com/doi/10.1097/JU.0000000000001201?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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