JCU - Abstracts of the BAUS 2018 Scientific Meeting - June 2018 - 61

Abstracts
Chahal R1, Singh R1, Addla S1, Yates 2, Heer R3,
Conford P4, Weston R4, Ramani V5, Lau M5, Kumar M6,
Faisal M7
1Bradford Teaching Hospitals Foundation Trust, United Kingdom,
2Sheffield Teaching Hospitals, UK, 3NUTHFT, Newcastle, UK,
4RLBUHT, Liverpool, UK, 5CNFT, Manchester, UK, 6WUTH, Wirral,
UK, 7University of Bradford, UK

Introduction: Accurate risk prediction is a prerequisite
for informed decision making. Current predictive models
are based on American and European data.
Materials and Methods: Prospectively data from 1499
consecutive patients from the NERUS (North of England
Robotic Urological Surgeons) database were used to
develop a predictive calculator.
Results: The mean PSA was 8.9. 49.8% were D'Amico
intermediate and 26.6% high risk. pT3a and T3b disease
was noted 35.4% and 5.3% and the specimen prognostic
grades t 3 in 25.9%. The data was divided into training
(70%) and testing (30%) to assess the performance of each
model using area under the receiver operating curve
(c-statistic). Age, PSA, DRE stage, biopsy prognostic grade,
D'Amico risk category were co-variates assessed. Risk
equations for pathological stage T2, T3a and T3b and pathological prognostic grade were developed. Discrimination
(c-statistic) of 0.74 and 0.71 was noted overall for the
training and testing for pathological stage and 0.73 and
0.74 for prognostic grade. The similar values in testing and
training sets indicate good internal validity. Discrimination
for pT3b was 0.84 and grade 5 was 0.82. A calculator was
developed with 5 input data points (above) to predict
pathological stage pT2, pT3a and pT3b and prognostic
grades 1-5.
Conclusions: We have developed a simple excel based
calculator based on a large, multi-institutional cohort of
contemporary patients to predict pathological stage pT2,
pT3a and pT3b and prognostic grades 1-5 in patients
undergoing robotic prostatectomy.There is good discrimination and internal validation making them applicable in
regular clinical practice.
P6-11 A single centre experience in treating
localised prostate cancer with focal HIFU
ablation over 8 years
Hanna M1, Johnston M1, Thorman H1, Bott S2, Emara
A1, Hindley R1
1Basingstoke and North Hampshire Hospital, United Kingdom,
2Frimley Park Hospital, Camberley, United Kingdom

Introduction: With improving accuracy in diagnosis and
identification of index prostate cancer lesions, focal ablation has become a more palatable approach for treating
significant unilateral disease, this technique was adopted in
our centre 8 years ago. Here we report our intermediate
outcomes.

61
Patients and Methods: 149 men underwent partial
gland HIFU. Diagnostics included PSA, MpMRI, mapping
biopsies followed by focal ablation of significant cancer as
defined by the UCL criteria. Follow-up MRI, PSA, QOL
questionnaires, biopsy for cause, and redo HIFU if required
as part of the treatment strategy per EAU International
Multidisciplinary Consensus on Trial Design for Focal
Therapy guidelines.
Results: Mean age of 66 years, 89% of subjects had intermediate/high risk disease, and mean pre-HIFU PSA was 7.4.
31% had high volume Gleason 6 disease, 55% had Gleason
3+4 disease, and 13% had Gleason 4+3 disease. 61%
received a Hemi-ablation, 31% a focal ablation, and 8% a
quadrant ablation. Mean follow-up was 40 months, subjects' PSA dropped to an average 70% nadir. 8% had BCR.
6% required salvage treatment (five men underwent radical
prostatectomy, four with radiotherapy). Freedom from
additional procedures for clinically significant recurrent disease, including redo-HIFU, was 83%. Post-operative complications included 0.6% new use of pads, 1.3% urethral
stricture, 2.6% post-HIFU TURP, and new onset ED of 14%.
Conclusion: In a carefully chosen cohort of patients for
focal HIFU our results suggests acceptable oncological
control with minimal post-operative morbidity. Further
studies are required to establish this technique as a less
morbid alternative to radical therapy.
P6-12 A phase III study comparing
partial prostate ablation versus radical
prostatectomy (PART) in intermediate
risk prostate cancer - initial data from the
feasibility study
Leslie T1, Elliott D3, Davies L2, Burns R2, Le Conte S2,
Thomson C2, Gray R2, Wolstenholme J2, Verrill C2,
Fitzpatrick R2, Gleeson F2, Rosario D4, Catto J4, Bryant
R2, Lamb A2, Brewster S1, Dudderidge T5, Hindley R6,
Sooriakumaran P7, Ahmed H8, Donovan J3, Hamdy F2
1Oxford University Hospitals NHS Foundation Trust, United
Kingdom, 2Nuffield Department of Surgical Sciences, University
of Oxford, United Kingdom, 3Population Health Sciences, Bristol
Medical School, University of Bristol, United Kingdom, 4Department
of Oncology & Metabolism, University of Sheffield, United Kingdom,
5University Hospital Southampton NHS Foundation Trust, United
Kingdom, 6Hampshire Hospitals NHS Foundation Trust, Basingstoke,
United Kingdom, 7University College London Hospital NHS
Foundation Trust, United Kingdom, 8Department of Surgery &
Cancer, Imperial College London, United Kingdom

Background: Men with intermediate-risk, localised prostate cancer (PCa) are offered radical treatments (RT) such
as radical prostatectomy (RP), which can cause significant
side-effects. Alternatively, partial ablation (PA) technologies are now available, which may reduce treatment burden. RT versus PA has never been evaluated in a randomised
clinical trial (RCT).

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