Evidence map›Paper›PMID 37385981›Full record

ArticleBJU international2023

External validation of a risk model predicting failure of salvage focal ablation for prostate cancer.

Alexander Light, Max Peters, Deepika Reddy, Abi Kanthabalan, Marjorie Otieno, Menelaos Pavlou, Rumana Omar, Sola Adeleke, Francesco Giganti, Chris Brew-Graves and 22 more

Registry-linked trialOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BJU international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01883128 (An Evaluation of a Novel Imaging Based Complex Diagnostic and Therapeutic Pathway Intervention for Men Who Fail Radiotherapy for Prostate Cancer.), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 30% 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.

NCT01883128 phase2unknown statusnot on this map

An Evaluation of a Novel Imaging Based Complex Diagnostic and Therapeutic Pathway Intervention for Men Who Fail Radiotherapy for Prostate Cancer.

TypeinterventionalSponsorUniversity College London HospitalsRan2014 to 2019Enrolled177ConditionsProgression of Prostate CancerArmsWhole Body MRI, Focal Salvage Therapy, MRI Targeted biopsies
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors at 13 institutions in 2 countries.

Alexander LightImperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID 0000-0001-7246-3651
Max PetersDepartment of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
Deepika ReddyImperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID 0000-0001-6889-0378
Abi KanthabalanDivision of Surgery and Interventional Sciences, University College London, London, UK.ORCID 0000-0003-1599-2455
Marjorie OtienoDivision of Surgery and Interventional Sciences, University College London, London, UK.
Menelaos PavlouDepartment of Statistical Science, University College London, London, UK.
Rumana OmarDepartment of Statistical Science, University College London, London, UK.
Sola AdelekeDepartment of Oncology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Francesco GigantiDivision of Surgery and Interventional Sciences, University College London, London, UK.
Chris Brew-GravesDivision of Medicine, Faculty of Medicine, University College London, London, UK.
Norman R WilliamsDivision of Surgery and Interventional Sciences, University College London, London, UK.
Amr EmaraDepartment of Urology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
Athar HaroonInstitute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
Arash LatifoltojarDivision of Medicine, Faculty of Medicine, University College London, London, UK.
Harbir SidhuDivision of Medicine, Faculty of Medicine, University College London, London, UK.
Alex FreemanDepartment of Histopathology, University College London Hospital NHS Foundation Trust, London, UK.
Clement OrczykDivision of Surgery and Interventional Sciences, University College London, London, UK.ORCID 0000-0003-3067-2409
Ashok NikapotaSussex Cancer Centre, Royal Sussex County Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK.
Tim DudderidgeDepartment of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Richard G HindleyDepartment of Urology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.
Jaspal VirdiDepartment of Urology, The Princess Alexandra Hospital NHS Trust, Harlow, UK.
Manit AryaImperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.
Heather PayneDepartment of Histopathology, University College London Hospital NHS Foundation Trust, London, UK.
Anita V MitraDepartment of Oncology, University College London Hospital NHS Foundation Trust, London, UK.
Jamshed BomanjiInstitute of Nuclear Medicine, University College London Hospitals NHS Foundation Trust, London, UK.
Mathias WinklerImperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK.
Gail HoranDepartment of Oncology, Queen Elizabeth Hospital, The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust, King's Lynn, UK.
Caroline MooreDivision of Surgery and Interventional Sciences, University College London, London, UK.ORCID 0000-0003-0202-7912
Mark EmbertonDivision of Surgery and Interventional Sciences, University College London, London, UK.ORCID 0000-0003-4230-0338
Shonit PunwaniDivision of Medicine, Faculty of Medicine, University College London, London, UK.ORCID 0000-0002-1014-0870
Hashim U AhmedImperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID 0000-0003-1674-6723
Taimur T ShahImperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID 0000-0003-1642-1208
University College London Hospitals NHS Foundation Trust · GBImperial College Healthcare NHS Trust · GBUniversity College London · GBHampshire Hospitals NHS Foundation Trust · GBFaculty (United Kingdom) · GBKing's College London · GBPrincess Alexandra Hospital NHS Trust · GBQueen Elizabeth Hospital King's Lynn NHS Foundation Trust · GBRoyal Marsden NHS Foundation Trust · GBRoyal Sussex County Hospital · GBSt Bartholomew's Hospital · GBUniversity Hospital Southampton NHS Foundation Trust · GBUniversity Medical Center Utrecht · NL

Funding

Focal HIFU Ablation of Prostate Cancer Using Advanced Ultrasound GuidanceR01CA135089 · NCI · RIVERSIDE RESEARCH INSTITUTE · PI FELEPPA, ERNEST JOSEPH, SANGHVI, NARENDRA T · 2010 to 2013
$2.1M
Medical Research CouncilNCI NIH HHS R01 CA135089NIH HHSWellcome Trust
6 · The paper itself

Abstract

objectivesTo externally validate a published model predicting failure within 2 years after salvage focal ablation in men with localised radiorecurrent prostate cancer using a prospective, UK multicentre dataset. PATIENTS AND

methodsPatients with biopsy-confirmed ≤T3bN0M0 cancer after previous external beam radiotherapy or brachytherapy were included from the FOcal RECurrent Assessment and Salvage Treatment (FORECAST) trial (NCT01883128; 2014-2018; six centres), and from the high-intensity focussed ultrasound (HIFU) Evaluation and Assessment of Treatment (HEAT) and International Cryotherapy Evaluation (ICE) UK-based registries (2006-2022; nine centres). Eligible patients underwent either salvage focal HIFU or cryotherapy, with the choice based predominantly on anatomical factors. Per the original multivariable Cox regression model, the predicted outcome was a composite failure outcome. Model performance was assessed at 2 years post-salvage with discrimination (concordance index [C-index]), calibration (calibration curve and slope), and decision curve analysis. For the latter, two clinically-reasonable risk threshold ranges of 0.14-0.52 and 0.26-0.36 were considered, corresponding to previously published pooled 2-year recurrence-free survival rates for salvage local treatments.

resultsA total of 168 patients were included, of whom 84/168 (50%) experienced the primary outcome in all follow-ups, and 72/168 (43%) within 2 years. The C-index was 0.65 (95% confidence interval 0.58-0.71). On graphical inspection, there was close agreement between predicted and observed failure. The calibration slope was 1.01. In decision curve analysis, there was incremental net benefit vs a 'treat all' strategy at risk thresholds of ≥0.23. The net benefit was therefore higher across the majority of the 0.14-0.52 risk threshold range, and all of the 0.26-0.36 range.

conclusionIn external validation using prospective, multicentre data, this model demonstrated modest discrimination but good calibration and clinical utility for predicting failure of salvage focal ablation within 2 years. This model could be reasonably used to improve selection of appropriate treatment candidates for salvage focal ablation, and its use should be considered when discussing salvage options with patients. Further validation in larger, international cohorts with longer follow-up is recommended.

Indexed as

Prostatic NeoplasmsSalvage TherapyBiopsyBrachytherapyClinical Trials as TopicHumansMaleMulticenter Studies as TopicNeoplasm Recurrence, LocalProspective StudiesTreatment Outcomeablationcryotherapyfailurefocal therapyhigh-intensity focussed ultrasoundprediction modelprostate cancerradiotherapyrecurrencesalvage

Identifiers

PMID37385981
PMCPMC10615865
OpenAlexW4382602532

What OpenQuestion holds

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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.