Evidence map›Paper›PMID 33934114›Full record

ArticleProstate cancer and prostatic diseases2021

Conventional radical versus focal treatment for localised prostate cancer: a propensity score weighted comparison of 6-year tumour control.

Marieke J van Son, Max Peters, Deepika Reddy, Taimur T Shah, Feargus Hosking-Jervis, Stephen Robinson, Jan J W Lagendijk, Stephen Mangar, Tim Dudderidge, Stuart McCracken and 14 more

Abstract readComparative StudyMulticenter Study
PubMed Publisher
In one paragraph

Article in Prostate cancer and prostatic diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 9% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.

  1. Pooled it
  2. 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
  3. Article
  4. Article
  5. Review
  6. Focal therapy for prostate cancer.Abdominal radiology (New York) · 2025
    Review
  7. Review
  8. Article
  9. Article
  10. Article
  11. Article
  12. Review
  13. Review
  14. Review
  15. Focal therapy for prostate cancer-ready to be a standard of care?Prostate cancer and prostatic diseases · 2021
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 11 institutions in 2 countries.

Marieke J van SonImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK. M.J.vanSon-3@umcutrecht.nl.ORCID http://orcid.org/0000-0002-1886-6385
Max PetersImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0002-7981-5768
Deepika ReddyImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Taimur T ShahImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Feargus Hosking-JervisImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Stephen RobinsonDivision of Clinical Oncology, Department of Radiotherapy, Charing Cross Hospital, Imperial College London Healthcare NHS Trust, London, UK.ORCID http://orcid.org/0000-0003-0623-4636
Jan J W LagendijkDepartment of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
Stephen MangarImperial Urology, Imperial College Healthcare NHS Trust, London, UK.
Tim DudderidgeDepartment of Urology, University Hospital Southampton NHS Trust, Southampton, UK.
Stuart McCrackenDepartment of Urology, Sunderland Royal Hospital, City Hospital Foundation Trust, Sunderland, UK.
Richard G HindleyDepartment of Urology, Hampshire Hospitals & Ain Shams University Hospitals, Basingstoke, UK.
Amr EmaraDepartment of Urology, Hampshire Hospitals & Ain Shams University Hospitals, Basingstoke, UK.
Raj NigamBMI Mount Alvernia Hospital, Guildford, Surrey, UK.
Raj PersadDepartment of Urology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
Jaspal VirdiDepartment of Urology, Princes Alexandra Hospital NHS Trust, Harlow, UK.
Henry LewiSpringfield Hospital, Chelmsford, UK.
Caroline MooreDepartment of Surgery and Interventional Sciences, University College London, and University College Hospital London, London, UK.ORCID http://orcid.org/0000-0003-0202-7912
Clement OrczykDepartment of Surgery and Interventional Sciences, University College London, and University College Hospital London, London, UK.
Mark EmbertonDepartment of Surgery and Interventional Sciences, University College London, and University College Hospital London, London, UK.ORCID http://orcid.org/0000-0003-4230-0338
Manit AryaImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Hashim U AhmedImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0003-1674-6723
Jochem R N van der Voort van Zyp *Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
Matt Winkler *Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.ORCID http://orcid.org/0000-0002-2553-5816
Alison Falconer *Imperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
Imperial College Healthcare NHS Trust · GBUniversity College Hospital · GBHampshire Hospitals NHS Foundation Trust · GBImperial College London · GBSunderland Royal Hospital · GBCharing Cross Hospital · GBMount Alvernia Hospital · GBNorth Bristol NHS Trust · GBPrincess Alexandra Hospital NHS Trust · GBSpringfield Hospital · GBUniversity Hospital Southampton NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor localised prostate cancer, focal therapy offers an organ-sparing alternative to radical treatments (radiotherapy or prostatectomy). Currently, there is no randomised comparative effectiveness data evaluating cancer control of both strategies.

methodsFollowing the eligibility criteria PSA < 20 ng/mL, Gleason score ≤ 7 and T-stage ≤ T2c, we included 830 radical (440 radiotherapy, 390 prostatectomy) and 530 focal therapy (cryotherapy, high-intensity focused ultrasound or high-dose-rate brachytherapy) patients treated between 2005 and 2018 from multicentre registries in the Netherlands and the UK. A propensity score weighted (PSW) analysis was performed to compare failure-free survival (FFS), with failure defined as salvage treatment, metastatic disease, systemic treatment (androgen deprivation therapy or chemotherapy), or progression to watchful waiting. The secondary outcome was overall survival (OS). Median (IQR) follow-up in each cohort was 55 (28-83) and 62 (42-83) months, respectively.

resultsAt baseline, radical patients had higher PSA (10.3 versus 7.9) and higher-grade disease (31% ISUP 3 versus 11%) compared to focal patients. After PSW, all covariates were balanced (SMD < 0.1). 6-year weighted FFS was higher after radical therapy (80.3%, 95% CI 73.9-87.3) than after focal therapy (72.8%, 95% CI 66.8-79.8) although not statistically significant (p = 0.1). 6-year weighted OS was significantly lower after radical therapy (93.4%, 95% CI 90.1-95.2 versus 97.5%, 95% CI 94-99.9; p = 0.02). When compared in a three-way analysis, focal and LRP patients had a higher risk of treatment failure than EBRT patients (p < 0.001), but EBRT patients had a higher risk of mortality than focal patients (p = 0.008).

conclusionsWithin the limitations of a cohort-based analysis in which residual confounders are likely to exist, we found no clinically relevant difference in cancer control conferred by focal therapy compared to radical therapy at 6 years.

Indexed as

AgedAndrogen AntagonistsAntineoplastic AgentsBiomarkers, TumorBrachytherapyCryotherapyDisease ProgressionHigh-Intensity Focused Ultrasound AblationHumansMaleMiddle AgedNeoplasm GradingNeoplasm StagingNetherlandsPropensity ScoreProstatectomyAndrogen AntagonistsAntineoplastic AgentsBiomarkers, TumorProstate-Specific Antigen

Identifiers

PMID33934114
OpenAlexW3159078112

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.