Tony Finelli

MD, MSc, FRCSC

Chief of Urology, University Health Network
GU Site Lead, Princess Margaret Cancer Center
Associate Professor
University of Toronto

Phone

(416) 946-2851

Assistant(s)

Biography

Dr. Tony Finelli is a urologic oncologist and surgeon investigator at the University Health Network (UHN) in Toronto and an Associate Professor at the University of Toronto. He is the Chief of Urology, GU Site Lead at the Princess Margaret Cancer Center and the inaugural GU Oncology Lead for the province of Ontario (Cancer Care Ontario).

Dr. Finelli conducts health services research in urologic oncology with an interest in identifying gaps in care and designing knowledge translation strategies to overcome them. He is also actively involved in clinical trials. He has published more than 100 peer-reviewed manuscripts and holds peer-reviewed funding for research in prostate and kidney cancer.

Dr. Finelli’s clinical practice focuses on the management of urologic malignancies with minimally invasive and robotic techniques. He has performed live surgery for instructional purposes in more than 10 countries. Dr Finelli is recognized nationally and internationally for his contributions to minimally invasive urologic oncology.

Areas of Specialty and Research Interests

Affiliated Hospital(s)

Princess Margaret Cancer Centre (UHN), Toronto General Hospital (UHN)
 
 

Latest Publications

Limitations in Predicting Organ Confined Prostate Cancer in Patients with Gleason Pattern 4 on Biopsy: Implications for Active Surveillance.

Icon for Wolters Kluwer Related Articles

Limitations in Predicting Organ Confined Prostate Cancer in Patients with Gleason Pattern 4 on Biopsy: Implications for Active Surveillance.

J Urol. 2017 01;197(1):75-83

Authors: Perlis N, Sayyid R, Evans A, Van Der Kwast T, Toi A, Finelli A, Kulkarni G, Hamilton R, Zlotta AR, Trachtenberg J, Ghai S, Fleshner NE

Abstract
PURPOSE: In prostate cancer biopsy Gleason score predicts stage and helps determine active surveillance suitability. Evidence suggests that small incremental differences in the quantitative percent of Gleason pattern 4 on biopsy stratify disease extent, biochemical failure following surgery and eligibility for active surveillance. We explored the overall quantitative percent of Gleason pattern 4 levels and adverse outcomes in patients with low and intermediate risk prostate cancer to whom active surveillance may be offered under expanded criteria.
MATERIALS AND METHODS: We analyzed the records of patients with biopsy Gleason score 6 (3 + 3) or 7 (3 + 4) who underwent radical prostatectomy from January 2008 to August 2015. Age, prostate specific antigen, Gleason score, quantitative percent of Gleason pattern 4, overall percent positive cores (percent of prostate cancer) and clinical stage were explored as predictors of nonorgan confined disease and time to failure after radical prostatectomy.
RESULTS: In 1,255 patients biopsy Gleason score 7 (3 + 4) was associated with T3 or greater disease at radical prostatectomy in 35.0% compared with Gleason score 6 (3 + 3) in 19.0% (p <0.001). On multivariate analysis for each quantitative percent of Gleason pattern 4 increase there were 2% higher odds of T3 or greater disease (OR 1.02, 95% CI 1.01-1.04, p <0.001). When stratified, patients with Gleason score 7 (3 + 4) only approximated the pT3 rates of Gleason score 6 (3 + 3) when prostate specific antigen was less than 8 ng/ml and the percent of prostate cancer was less than 15%. In those cases the quantitative percent of Gleason pattern 4 had less effect. Time to failure after radical prostatectomy was worse in Gleason score 7 (3 + 4) than 6 (3 + 3) cases.
CONCLUSIONS: The quantitative percent of Gleason pattern 4 helps predict advanced disease and Gleason score 7 (3 + 4) is associated with worse outcomes. However, the impact of the quantitative percent of Gleason pattern 4 on adverse pathological and clinical outcomes is best used in combination with prostate specific antigen, age and disease volume since each has a greater impact on predicting nonorgan confined disease. The calculated absolute risk of T3 or greater can be used in shared decision making on prostate cancer treatment by patients and clinicians.

PMID: 27457260 [PubMed - indexed for MEDLINE]