The Feasibility and Value of a Focal Therapy Multidisciplinary Tumor Board, Including Radiographic and Pathological Overreads in Refining the Selection for High Intensity Focused Ultrasound in Prostate Cancer Patients.
Urol Pract
; 10(4): 372-377, 2023 07.
Article
in En
| MEDLINE
| ID: mdl-37103528
ABSTRACT
INTRODUCTION:
Focal therapy for prostate cancer is increasingly recognized as an acceptable therapeutic option in well-selected men. A focal therapy multidisciplinary tumor board geared toward improving patient selection is a novel concept which has not been reported. We describe our institution's initial experience with a multidisciplinary tumor board for focal therapy and its outcomes in terms of patient selection.METHODS:
This was a single-center, prospective study of patients referred to a multidisciplinary tumor board. All prostate MRIs were re-reviewed by a single radiologist with >10 years of experience, and the number, size, location, and Prostate Imaging Reporting & Data System scores of lesions visible on MRI were recorded and compared to the original report. Outside histopathology, when requested, was also re-reviewed for cancer grade groups and adverse pathological features. A descriptive statistical analysis was performed.RESULTS:
Seventy-four patients were presented at our multidisciplinary tumor board (January-October 2022). Sixty-seven patients were treatment naïve, while 7 had prior radiation±androgen deprivation therapy. MRI overread was performed on all treatment-naïve patients (67/74 [91%]), while pathology overreads were performed on 14/74 (19.9%). Following multidisciplinary tumor board, 19 patients (25.6%) were deemed suitable candidates for focal therapy. A total of 24 patients (35.8%) were not deemed candidates for high intensity focused ultrasound focal therapy based exclusively on findings identified at MRI overread. Pathology re-review changed management for 3/14 patients, with two-thirds being downgraded to grade group 1 disease and opting for active surveillance.CONCLUSIONS:
Multidisciplinary tumor board for focal therapy is feasible. MRI overread is an essential component of this process and demonstrates significant findings that alter eligibility or management in over a third of patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prostatic Neoplasms
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Humans
/
Male
Language:
En
Journal:
Urol Pract
Year:
2023
Document type:
Article