Evidence map›Paper›PMID 29960750›Full record

ArticleEuropean urology2018

A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic Prostate Cancer.

Stephanie Guillaumier, Max Peters, Manit Arya, Naveed Afzal, Susan Charman, Tim Dudderidge, Feargus Hosking-Jervis, Richard G Hindley, Henry Lewi, Neil McCartan and 10 more

3 registry-linked trialsOpen access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European urology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 136 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
136citing papers in PubMed, 4 pooled it
23.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06929065 nacompletednot on this mapstarted 2023, after this paper: background citation

Randomized Prospective Trial of Focal Therapy (HIFU vs Cryo) for Early Stage Unifocal Prostate Cancer

TypeinterventionalSponsorKaiser PermanenteRan2023 to 2025Enrolled50ConditionsProstate Cancer, Prostate Cancer Stage I, Prostate Cancer Stage II, High Intensity Focused UltrasoundArmsHIFU vs Cryoablation
NCT07339943 narecruitingnot on this mapstarted 2025, after this paper: background citation

Micro-ultrasound-Guided Focal Laser Ablation (MicroUSgFLA) Treatment for Management of Intermediate-Risk Prostate Cancer: Evaluation of Safety and Effectiveness

TypeinterventionalSponsorUniversity Health Network, TorontoRan2025 to 2027Enrolled7ConditionsProstate Cancer (Adenocarcinoma), Low and Intermediate Risk Prostate CancerArms6 month, prospective, interventional single-arm safety and effectiveness study, The TRANBERG, CLS Thermal therapy
NCT07757490 recruitingnot on this map

SONAFUSION Registry (Long-term Evaluation of Sonablate High-Intensity Focused Ultrasound for the Treatment of Prostate Cancer and Benign Prostatic Hyperplasia)

Typeobservational_patient_registrySponsorSonablateRan2015 to 2035Enrolled10,000ConditionsLocalized Prostate Cancer, BPH (Benign Prostatic Hyperplasia), Prostate Cancer, Benign Prostatic HyperplasiaArmsHigh Intensity Focused Ultrasound
3 · Its place in the literature

Who cites it

136 citing papers in PubMed, 4 syntheses or guidelines pooled it, 309 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Available evidence on HIFU for focal treatment of prostate cancer: a systematic review.International braz j urol : official journal of the Brazilian Society of Urology
    Pooled it
  5. Prostate specific membrane antigen focal ablation imaging (PSMA-FAB).Prostate cancer and prostatic diseases · 2026
    Review
  6. MR Imaging/Ultrasound Fusion-Guided Biopsy and Primary Focal Therapy for Localized Prostate Cancer.Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine · 2026
    Review
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Frontiers of Ultrasound Technology in Prostate Cancer Treatment.International journal of urology : official journal of the Japanese Urological Association · 2025
    Review
  13. Article
  14. A Fully Populated Transrectal Array for Boiling Histotripsy Ablation of the Prostate.IEEE transactions on ultrasonics, ferroelectrics, and frequency control · 2025
    Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Surveillance after Focal Therapy - a Comprehensive Review.Prostate cancer and prostatic diseases · 2025
    Review
  20. Review

76 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 14 institutions in 2 countries.

Stephanie GuillaumierDivision of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, UCLH NHS Foundation Trust, London, UK.
Max PetersDepartment of Radiotherapy, University Medical Centre, Utrecht, The Netherlands.
Manit AryaDepartment of Urology, UCLH NHS Foundation Trust, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; Department of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK.
Naveed AfzalDepartment of Urology, Dorset County Hospital NHS Trust, Dorset, UK.
Susan CharmanDivision of Surgery and Interventional Sciences, University College London, London, UK.
Tim DudderidgeDepartment of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
Feargus Hosking-JervisDivision of Surgery and Interventional Sciences, University College London, London, UK; Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Richard G HindleyDepartment of Urology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
Henry LewiSpringfield Hospital, Chelmsford, UK.
Neil McCartanDivision of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, UCLH NHS Foundation Trust, London, UK.
Caroline M MooreDivision of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, UCLH NHS Foundation Trust, London, UK.
Raj NigamDepartment of Urology, Royal County Surrey Hospital NHS Trust, Guildford, UK.
Chris OgdenDepartment of Academic Urology, The Royal Marsden Hospital NHS Foundation Trust, London, UK.
Raj PersadDepartment of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Karishma ShahDivision of Surgery and Interventional Sciences, University College London, London, UK.
Jan van der MeulenLondon School of Hygiene and Tropical Medicine, London, UK.
Jaspal VirdiDepartment of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK.
Mathias WinklerImperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
Mark EmbertonDivision of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, UCLH NHS Foundation Trust, London, UK.
Hashim U AhmedDivision of Surgery and Interventional Sciences, University College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK. Electronic address: hashim.ahmed@imperial.ac.uk.
University College London · GBImperial College Healthcare NHS Trust · GBCharing Cross Hospital · GBDorset County Hospital NHS Foundation Trust · GBHampshire Hospitals NHS Foundation Trust · GBLondon School of Hygiene & Tropical Medicine · GBPrincess Alexandra Hospital NHS Trust · GBRoyal Marsden Hospital · GBRoyal Surrey County Hospital · GBSouthmead Hospital · GBSpringfield Hospital · GBUniversity College Hospital · GBUniversity Hospital Southampton NHS Foundation Trust · GBUniversity Medical Center Utrecht · NL

Funding

Medical Research Council G1002509
6 · The paper itself

Abstract

backgroundClinically significant nonmetastatic prostate cancer (PCa) is currently treated using whole-gland therapy. This approach is effective but can have urinary, sexual, and rectal side effects.

objectiveTo report on 5-yr PCa control following focal high-intensity focused ultrasound (HIFU) therapy to treat individual areas of cancer within the prostate. DESIGN, SETTING, AND

participantsThis was a prospective study of 625 consecutive patients with nonmetastatic clinically significant PCa undergoing focal HIFU therapy (Sonablate) in secondary care centres between January 1, 2006 and December 31, 2015. A minimum of 6-mo follow-up was available for599 patients. Intermediate- or high-risk PCa was found in 505 patients (84%).

interventionDisease was localised using multiparametric magnetic resonance imaging (mpMRI) combined with targeted and systematic biopsies, or transperineal mapping biopsies. Areas of significant disease were treated. Follow-up included prostate-specific antigen (PSA) measurement, mpMRI, and biopsies. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoint, failure-free survival (FFS), was defined as freedom from radical or systemic therapy, metastases, and cancer-specific mortality. RESULTS AND LIMITATIONS: The median follow-up was 56 mo (interquartile range [IQR] 35-70). The median age was 65 yr (IQR 61-71) and median preoperative PSA was 7.2 ng/ml (IQR 5.2-10.0). FFS was 99% (95% confidence interval [CI] 98-100%) at 1 yr, 92% (95% CI 90-95%) at 3 yr, and 88% (95% 85-91%) at 5 yr. For the whole patient cohort, metastasis-free, cancer-specific, and overall survival at 5 yr was 98% (95% CI 97-99%), 100%, and 99% (95% CI 97-100%), respectively. Among patients who returned validated questionnaires, 241/247 (98%) achieved complete pad-free urinary continence and none required more than 1 pad/d. Limitations include the lack of long-term follow-up.

conclusionsFocal therapy for select patients with clinically significant nonmetastatic prostate cancer is effective in the medium term and has a low probability of side effects. PATIENT SUMMARY: In this multicentre study of 625 patients undergoing focal therapy using high-intensity focused ultrasound (HIFU), failure-free survival, metastasis-free survival, cancer-specific survival, and overall survival were 88%, 98%, 100%, and 99%, respectively. Urinary incontinence (any pad use) was 2%. Focal HIFU therapy for patients with clinically significant prostate cancer that has not spread has a low probability of side effects and is effective at 5 yr.

Indexed as

ProstateProstatic NeoplasmsUltrasound, High-Intensity Focused, TransrectalAgedBiopsyFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedNeoplasm StagingOutcome Assessment, Health CareProspective StudiesProstate-Specific AntigenRegistriesSurvival AnalysisProstate-Specific AntigenFocal therapyHigh-intensity focused ultrasoundMultiparametric magnetic resonance imagingTargeted biopsyTransperineal biopsy

Identifiers

PMID29960750
PMCPMC6156573
OpenAlexW2810125259

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.