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Identifying the Index Lesion

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Imaging and Focal Therapy of Early Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

Academic and professional resistance to focal prostate therapy has been dominated by the fact that it is a multifocal disease. As such, until focal therapy became a legitimate research question, no attempt was made to distinguish between those men with unifocal cancer and those with multifocal disease since this information had little clinical utility in decision making for therapy. Over the last 5 years, there has also been growing evidence that the risk of disease progression to local invasion, metastases, and death is likely to be monoclonal in origin with the largest dominant, or so-called index lesion, responsible for this. This chapter reviews the considerable body of evidence that has grown to support this hypothesis.

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Funding Sources and Acknowledgements

H.U. Ahmed and M. Emberton receive funding from the Medical Research Council, UK NIHR-HTA, Pelican Cancer Foundation, Prostate Action, Prostate Cancer Research Centre and St Peters Trust for work on focal therapy and ­imaging of prostate cancer. M. Emberton has also been funded in part by the UCH/UCL NIHR Comprehensive Biomedical Research Centre.

Author information

Authors and Affiliations

  1. General Hospital of Nikea, Piraeus, Athens, Greece

    Markos Karavitakis M.D., M.Sc., D.I.C.

  2. Department of Urology, University of Athens Medical School, Dim. Mantouvalou 3, Piraeus, Athens, 18450, Greece

    Markos Karavitakis M.D., M.Sc., D.I.C.

  3. Department of Experimental Physiology, University of Athens Medical School, Dim. Mantouvalou 3, Piraeus, Athens, 18450, Greece

    Markos Karavitakis M.D., M.Sc., D.I.C.

  4. Division of Surgical and Interventional Sciences and Department of Urology, University College London and University College Hospitals NHS Foundation, Trust, 250 Euston Road, London, NW1 2PG, UK

    Mark Emberton M.D., F.R.C.S.(Urol.)

  5. Division of Surgery and Interventional Science, University College London & NIHR UCH/UCL Comprehensive Biomedical Research Centre, 67 Riding House Street, London, W1P 7NN, UK

    Hashim Uddin Ahmed M.R.C.S. (Ed), B.M., B.Ch. (Oxon)

Authors
  1. Markos Karavitakis M.D., M.Sc., D.I.C.
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  2. Mark Emberton M.D., F.R.C.S.(Urol.)
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  3. Hashim Uddin Ahmed M.R.C.S. (Ed), B.M., B.Ch. (Oxon)
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Corresponding author

Correspondence to Hashim Uddin Ahmed M.R.C.S. (Ed), B.M., B.Ch. (Oxon) .

Editor information

Editors and Affiliations

  1. , Department of Surgery, Duke Cancer Institute, Room 1089 Duke South, Durham, 27710, North Carolina, USA

    Thomas J. Polascik

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Karavitakis, M., Emberton, M., Ahmed, H.U. (2013). Identifying the Index Lesion. In: Polascik, T. (eds) Imaging and Focal Therapy of Early Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-182-0_5

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  • DOI: https://doi.org/10.1007/978-1-62703-182-0_5

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  • Publisher Name: Humana Press, Totowa, NJ

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