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Index Lesion

MedGen UID:
822295
•Concept ID:
C3829547
•
Finding

Definition

The most clinically significant tumor lesion targeted by therapy. The lesion is typically the largest or highest graded of the tumor foci detected. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVIndex Lesion

Professional guidelines

PubMed

Partial gland ablation in the management of prostate cancer: a review.
McClure TD, Margolis DJ, Hu JC
Curr Opin Urol 2017 Mar;27(2):156-160. doi: 10.1097/MOU.0000000000000376. PMID: 28033149
Optimal surgical management for high-risk populations.
King TA, Pilewskie M, Morrow M
Breast 2015 Nov;24 Suppl 2:S91-5. Epub 2015 Oct 1 doi: 10.1016/j.breast.2015.07.022. PMID: 26432360
Focal therapy for prostate cancer: rationale and treatment opportunities.
Kasivisvanathan V, Emberton M, Ahmed HU
Clin Oncol (R Coll Radiol) 2013 Aug;25(8):461-73. Epub 2013 Jun 4 doi: 10.1016/j.clon.2013.05.002. PMID: 23759249Free PMC Article

Recent clinical studies

Etiology

Interactive Explainable Deep Learning Model Informs Prostate Cancer Diagnosis at MRI.
Hamm CA, Baumgärtner GL, Biessmann F, Beetz NL, Hartenstein A, Savic LJ, Froböse K, Dräger F, Schallenberg S, Rudolph M, Baur ADJ, Hamm B, Haas M, Hofbauer S, Cash H, Penzkofer T
Radiology 2023 May;307(4):e222276. Epub 2023 Apr 11 doi: 10.1148/radiol.222276. PMID: 37039688
Focal therapy of localized prostate cancer.
Fujihara A, Ukimura O
Int J Urol 2022 Nov;29(11):1254-1263. Epub 2022 Aug 22 doi: 10.1111/iju.14991. PMID: 35996758
Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trial.
Garin E, Tselikas L, Guiu B, Chalaye J, Edeline J, de Baere T, Assenat E, Tacher V, Robert C, Terroir-Cassou-Mounat M, Mariano-Goulart D, Amaddeo G, Palard X, Hollebecque A, Kafrouni M, Regnault H, Boudjema K, Grimaldi S, Fourcade M, Kobeiter H, Vibert E, Le Sourd S, Piron L, Sommacale D, Laffont S, Campillo-Gimenez B, Rolland Y; DOSISPHERE-01 Study Group
Lancet Gastroenterol Hepatol 2021 Jan;6(1):17-29. Epub 2020 Nov 7 doi: 10.1016/S2468-1253(20)30290-9. PMID: 33166497
A Novel Nomogram to Identify Candidates for Extended Pelvic Lymph Node Dissection Among Patients with Clinically Localized Prostate Cancer Diagnosed with Magnetic Resonance Imaging-targeted and Systematic Biopsies.
Gandaglia G, Ploussard G, Valerio M, Mattei A, Fiori C, Fossati N, Stabile A, Beauval JB, Malavaud B, Roumiguié M, Robesti D, Dell'Oglio P, Moschini M, Zamboni S, Rakauskas A, De Cobelli F, Porpiglia F, Montorsi F, Briganti A
Eur Urol 2019 Mar;75(3):506-514. Epub 2018 Oct 17 doi: 10.1016/j.eururo.2018.10.012. PMID: 30342844
Prostate cancer multifocality, the index lesion, and the microenvironment.
Tourinho-Barbosa RR, de la Rosette J, Sanchez-Salas R
Curr Opin Urol 2018 Nov;28(6):499-505. doi: 10.1097/MOU.0000000000000537. PMID: 30138121

Diagnosis

Interactive Explainable Deep Learning Model Informs Prostate Cancer Diagnosis at MRI.
Hamm CA, Baumgärtner GL, Biessmann F, Beetz NL, Hartenstein A, Savic LJ, Froböse K, Dräger F, Schallenberg S, Rudolph M, Baur ADJ, Hamm B, Haas M, Hofbauer S, Cash H, Penzkofer T
Radiology 2023 May;307(4):e222276. Epub 2023 Apr 11 doi: 10.1148/radiol.222276. PMID: 37039688
Focal therapy for prostate cancer: recent advances and future directions.
Wang A, O'Connor LP, Yerram NK, Nandanan N, Ahdoot M, Lebastchi AH, Gurram S, Chalfin H, Pinto PA
Clin Adv Hematol Oncol 2020 Feb;18(2):116-125. PMID: 32558805
A Novel Nomogram to Identify Candidates for Extended Pelvic Lymph Node Dissection Among Patients with Clinically Localized Prostate Cancer Diagnosed with Magnetic Resonance Imaging-targeted and Systematic Biopsies.
Gandaglia G, Ploussard G, Valerio M, Mattei A, Fiori C, Fossati N, Stabile A, Beauval JB, Malavaud B, Roumiguié M, Robesti D, Dell'Oglio P, Moschini M, Zamboni S, Rakauskas A, De Cobelli F, Porpiglia F, Montorsi F, Briganti A
Eur Urol 2019 Mar;75(3):506-514. Epub 2018 Oct 17 doi: 10.1016/j.eururo.2018.10.012. PMID: 30342844
PET/MRI in Breast Cancer.
Pujara AC, Kim E, Axelrod D, Melsaether AN
J Magn Reson Imaging 2019 Feb;49(2):328-342. Epub 2018 Oct 6 doi: 10.1002/jmri.26298. PMID: 30291656
An update on prostate biopsy in the era of magnetic resonance imaging.
Cicione A, De Nunzio C, Manno S, Damiano R, Posti A, Lima E, Tubaro A, Balloni F
Minerva Urol Nefrol 2018 Jun;70(3):264-274. Epub 2018 Mar 28 doi: 10.23736/S0393-2249.18.03048-5. PMID: 29595039

Therapy

Focal therapy for prostate cancer: Making the punishment fit the crime.
Aoun F, Mjaess G, Abi Tayeh G, Sarkis J, Lilly E, Khalil N, Chebel R, Albisinni S, Roumeguère T, Peltier A
Prog Urol 2021 Dec;31(16):1080-1089. Epub 2021 Sep 16 doi: 10.1016/j.purol.2021.08.037. PMID: 34538741
Personalised versus standard dosimetry approach of selective internal radiation therapy in patients with locally advanced hepatocellular carcinoma (DOSISPHERE-01): a randomised, multicentre, open-label phase 2 trial.
Garin E, Tselikas L, Guiu B, Chalaye J, Edeline J, de Baere T, Assenat E, Tacher V, Robert C, Terroir-Cassou-Mounat M, Mariano-Goulart D, Amaddeo G, Palard X, Hollebecque A, Kafrouni M, Regnault H, Boudjema K, Grimaldi S, Fourcade M, Kobeiter H, Vibert E, Le Sourd S, Piron L, Sommacale D, Laffont S, Campillo-Gimenez B, Rolland Y; DOSISPHERE-01 Study Group
Lancet Gastroenterol Hepatol 2021 Jan;6(1):17-29. Epub 2020 Nov 7 doi: 10.1016/S2468-1253(20)30290-9. PMID: 33166497
Making a case "against" focal therapy for intermediate-risk prostate cancer.
Gontero P, Marra G, Teber D, Shariat S, Albayrak S, Coelho R, Tanguay S, Konety B
World J Urol 2021 Mar;39(3):719-728. Epub 2020 Jun 11 doi: 10.1007/s00345-020-03303-y. PMID: 32529451
Focal therapy of prostate cancer.
Hübner N, Shariat SF, Remzi M
Curr Opin Urol 2018 Nov;28(6):550-554. doi: 10.1097/MOU.0000000000000547. PMID: 30239415
Focal therapy: patients, interventions, and outcomes--a report from a consensus meeting.
Donaldson IA, Alonzi R, Barratt D, Barret E, Berge V, Bott S, Bottomley D, Eggener S, Ehdaie B, Emberton M, Hindley R, Leslie T, Miners A, McCartan N, Moore CM, Pinto P, Polascik TJ, Simmons L, van der Meulen J, Villers A, Willis S, Ahmed HU
Eur Urol 2015 Apr;67(4):771-7. Epub 2014 Oct 1 doi: 10.1016/j.eururo.2014.09.018. PMID: 25281389Free PMC Article

Prognosis

Identification of the Optimal Candidates for Nodal Staging with Extended Pelvic Lymph Node Dissection Among Prostate Cancer Patients Who Underwent Preoperative Prostate-specific Membrane Antigen Positron Emission Tomography. External Validation of the Memorial Sloan Kettering Cancer Center and Briganti Nomograms and Development of a Novel Tool.
Gandaglia G, Barletta F, Robesti D, Scuderi S, Rajwa P, Gomez Rivas J, Ibanez L, Soeterik TFW, Bianchi L, Afferi L, Kesch C, Darr C, Guo H, Zhuang J, Zattoni F, Fendler W, Marra G, Stabile A, Amparore D, Huebner NA, Giesen A, Joniau S, Schiavina R, Brunocilla E, Mattei A, Dal Moro F, Sierra JM, Porpiglia F, Picchio M, van den Bergh R, Shariat SF, Montorsi F, Briganti A
Eur Urol Oncol 2023 Dec;6(6):543-552. Epub 2023 Jun 1 doi: 10.1016/j.euo.2023.05.003. PMID: 37270378
Findings on Diagnostic Magnetic Resonance Imaging Before Radiotherapy for Prostate Cancer.
Dahan J, Delouya G, Lambert C, Olivié DAR, Billiard JS, Taussky D
Can Assoc Radiol J 2023 May;74(2):382-387. Epub 2022 Nov 3 doi: 10.1177/08465371221137278. PMID: 36325740
Focal therapy of localized prostate cancer.
Fujihara A, Ukimura O
Int J Urol 2022 Nov;29(11):1254-1263. Epub 2022 Aug 22 doi: 10.1111/iju.14991. PMID: 35996758
A Novel Nomogram to Identify Candidates for Extended Pelvic Lymph Node Dissection Among Patients with Clinically Localized Prostate Cancer Diagnosed with Magnetic Resonance Imaging-targeted and Systematic Biopsies.
Gandaglia G, Ploussard G, Valerio M, Mattei A, Fiori C, Fossati N, Stabile A, Beauval JB, Malavaud B, Roumiguié M, Robesti D, Dell'Oglio P, Moschini M, Zamboni S, Rakauskas A, De Cobelli F, Porpiglia F, Montorsi F, Briganti A
Eur Urol 2019 Mar;75(3):506-514. Epub 2018 Oct 17 doi: 10.1016/j.eururo.2018.10.012. PMID: 30342844
PET/MRI in Breast Cancer.
Pujara AC, Kim E, Axelrod D, Melsaether AN
J Magn Reson Imaging 2019 Feb;49(2):328-342. Epub 2018 Oct 6 doi: 10.1002/jmri.26298. PMID: 30291656

Clinical prediction guides

Interactive Explainable Deep Learning Model Informs Prostate Cancer Diagnosis at MRI.
Hamm CA, Baumgärtner GL, Biessmann F, Beetz NL, Hartenstein A, Savic LJ, Froböse K, Dräger F, Schallenberg S, Rudolph M, Baur ADJ, Hamm B, Haas M, Hofbauer S, Cash H, Penzkofer T
Radiology 2023 May;307(4):e222276. Epub 2023 Apr 11 doi: 10.1148/radiol.222276. PMID: 37039688
MRI-targeted biopsy cores from prostate index lesions: assessment and prediction of the number needed.
Beetz NL, Dräger F, Hamm CA, Shnayien S, Rudolph MM, Froböse K, Elezkurtaj S, Haas M, Asbach P, Hamm B, Mahjoub S, Konietschke F, Wechsung M, Balzer F, Cash H, Hofbauer S, Penzkofer T
Prostate Cancer Prostatic Dis 2023 Sep;26(3):543-551. Epub 2022 Oct 8 doi: 10.1038/s41391-022-00599-2. PMID: 36209237Free PMC Article
A Novel Nomogram to Identify Candidates for Extended Pelvic Lymph Node Dissection Among Patients with Clinically Localized Prostate Cancer Diagnosed with Magnetic Resonance Imaging-targeted and Systematic Biopsies.
Gandaglia G, Ploussard G, Valerio M, Mattei A, Fiori C, Fossati N, Stabile A, Beauval JB, Malavaud B, Roumiguié M, Robesti D, Dell'Oglio P, Moschini M, Zamboni S, Rakauskas A, De Cobelli F, Porpiglia F, Montorsi F, Briganti A
Eur Urol 2019 Mar;75(3):506-514. Epub 2018 Oct 17 doi: 10.1016/j.eururo.2018.10.012. PMID: 30342844
PET/MRI in Breast Cancer.
Pujara AC, Kim E, Axelrod D, Melsaether AN
J Magn Reson Imaging 2019 Feb;49(2):328-342. Epub 2018 Oct 6 doi: 10.1002/jmri.26298. PMID: 30291656
Focal therapy: patients, interventions, and outcomes--a report from a consensus meeting.
Donaldson IA, Alonzi R, Barratt D, Barret E, Berge V, Bott S, Bottomley D, Eggener S, Ehdaie B, Emberton M, Hindley R, Leslie T, Miners A, McCartan N, Moore CM, Pinto P, Polascik TJ, Simmons L, van der Meulen J, Villers A, Willis S, Ahmed HU
Eur Urol 2015 Apr;67(4):771-7. Epub 2014 Oct 1 doi: 10.1016/j.eururo.2014.09.018. PMID: 25281389Free PMC Article

Recent systematic reviews

Systematic review with meta-analysis: incidence and factors for progression to advanced neoplasia in inflammatory bowel disease patients with indefinite and low-grade dysplasia.
Wan J, Wang X, Zhang Y, Chen M, Wang M, Wu K, Liang J
Aliment Pharmacol Ther 2022 Mar;55(6):632-644. Epub 2022 Feb 15 doi: 10.1111/apt.16789. PMID: 35166389
Risk factors for gastric metachronous lesions after endoscopic or surgical resection: a systematic review and meta-analysis.
Ortigão R, Figueirôa G, Frazzoni L, Pimentel-Nunes P, Hassan C, Dinis-Ribeiro M, Fuccio L, Libânio D
Endoscopy 2022 Sep;54(9):892-901. Epub 2022 Feb 1 doi: 10.1055/a-1724-7378. PMID: 35104897
Accuracy of MRI-guided Versus Systematic Prostate Biopsy in Patients Under Active Surveillance: A Systematic Review and Meta-analysis.
Baccaglini W, Glina FA, Pazeto CL, Medina LG, Korkes F, Bernardo WM, Sotelo R, Glina S, Marra G, Moschini M, Cathelineau X, Sanchez-Salas R
Clin Genitourin Cancer 2021 Feb;19(1):3-11.e1. Epub 2020 Jul 2 doi: 10.1016/j.clgc.2020.06.008. PMID: 32839133
Meta-analysis of trials comparing laparoscopic transperitoneal and retroperitoneal adrenalectomy.
Nigri G, Rosman AS, Petrucciani N, Fancellu A, Pisano M, Zorcolo L, Ramacciato G, Melis M
Surgery 2013 Jan;153(1):111-9. Epub 2012 Aug 30 doi: 10.1016/j.surg.2012.05.042. PMID: 22939744
Understanding the pathological features of focality, grade and tumour volume of early-stage prostate cancer as a foundation for parenchyma-sparing prostate cancer therapies: active surveillance and focal targeted therapy.
Mouraviev V, Villers A, Bostwick DG, Wheeler TM, Montironi R, Polascik TJ
BJU Int 2011 Oct;108(7):1074-85. Epub 2011 Apr 13 doi: 10.1111/j.1464-410X.2010.10039.x. PMID: 21489116

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