@article{discovery10098913,
           title = {The Role of Percentage of Prostate-specific Antigen Reduction After Focal Therapy Using High-intensity Focused Ultrasound for Primary Localised Prostate Cancer. Results from a Large Multi-institutional Series},
           pages = {155--160},
          volume = {78},
            note = {This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.},
         journal = {European Urology},
            year = {2020},
           month = {August},
          number = {2},
        keywords = {Focal therapy, High-intensity focused ultrasound, Minimally invasive therapy, Outcome, Prostate cancer, Therapy},
             url = {https://doi.org/10.1016/j.eururo.2020.04.068},
          author = {Stabile, A and Orczyk, C and Giganti, F and Moschini, M and Allen, C and Punwani, S and Cathala, N and Ahmed, HU and Cathelineau, X and Montorsi, F and Emberton, M and Briganti, A and Sanchez-Salas, R and Moore, CM},
        abstract = {Focal therapy (FT) for prostate cancer (PCa) is emerging as a novel therapeutic approach for patients with low- to intermediate-risk disease, in order to provide acceptable oncological control, whilst avoiding the side effects of radical treatment. Evidence regarding the ideal follow-up strategy and the significance of prostate-specific antigen (PSA) kinetics after treatment is needed. In this study, we aimed to assess the value of the percentage of PSA reduction (\%PSA reduction) after FT in predicting the likelihood of any additional treatment or any radical treatment. We retrospectively analysed a multicentre cohort of 703 men receiving FT for low- and intermediate-risk PCa. Overall, the rates of any additional treatment and any radical treatment were 30\% and 13\%, respectively. The median follow-up period was 41 mo. The median \%PSA reduction after FT was 73\%. At Cox multivariable analysis, \%PSA reduction was an independent predictor of any additional treatment (hazard ratio [HR]: 0.96; p {\ensuremath{<}} 0.001) and radical treatment (HR: 0.97; p {\ensuremath{<}} 0.001) after FT. For \%PSA reduction of{\ensuremath{>}}90\%, the probability of any additional treatment within 5 yr was 20\%. Conversely, for \%PSA reduction of {\ensuremath{<}}10\%, the probability of receiving any additional treatment within 5 yr was roughly 70\%. This study is the first to assess the role of \%PSA reduction in the largest multicentre cohort of men receiving FT for PCa. Given the lack of standardised follow-up strategies in the FT field, the use of the \%PSA reduction should be considered.}
}