{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:55:03Z","timestamp":1770987303383,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000872","name":"Pelican Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000872","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To externally validate a published model predicting failure within 2\u2009years after salvage focal ablation in men with localised radiorecurrent prostate cancer using a prospective, UK multicentre dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>Patients with biopsy\u2010confirmed \u2264T3bN0M0 cancer after previous external beam radiotherapy or brachytherapy were included from the FOcal RECurrent Assessment and Salvage Treatment (FORECAST) trial (NCT01883128; 2014\u20132018; six centres), and from the high\u2010intensity focussed ultrasound (HIFU) Evaluation and Assessment of Treatment (HEAT) and International Cryotherapy Evaluation (ICE) UK\u2010based registries (2006\u20132022; 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\u2009years post\u2010salvage with discrimination (concordance index [C\u2010index]), calibration (calibration curve and slope), and decision curve analysis. For the latter, two clinically\u2010reasonable risk threshold ranges of 0.14\u20130.52 and 0.26\u20130.36 were considered, corresponding to previously published pooled 2\u2010year recurrence\u2010free survival rates for salvage local treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 168 patients were included, of whom 84\/168 (50%) experienced the primary outcome in all follow\u2010ups, and 72\/168 (43%) within 2\u2009years. The C\u2010index was 0.65 (95% confidence interval 0.58\u20130.71). 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 \u2018treat all\u2019 strategy at risk thresholds of \u22650.23. The net benefit was therefore higher across the majority of the 0.14\u20130.52 risk threshold range, and all of the 0.26\u20130.36 range.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In 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\u2009years. 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\u2010up is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16102","type":"journal-article","created":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T22:54:42Z","timestamp":1688079282000},"page":"520-530","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["External validation of a risk model predicting failure of salvage focal ablation for prostate cancer"],"prefix":"10.1111","volume":"132","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-3651","authenticated-orcid":false,"given":"Alexander","family":"Light","sequence":"first","affiliation":[{"name":"Imperial Prostate, Department of Surgery and Cancer Imperial College London  London UK"},{"name":"Imperial Urology, Charing Cross Hospital Imperial College Healthcare NHS Trust  London 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