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

International Multicenter Validation of an Intermediate Risk Subclassification of Prostate Cancer Managed with Radical Treatment without Hormone Therapy.

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International Multicenter Validation of an Intermediate Risk Subclassification of Prostate Cancer Managed with Radical Treatment without Hormone Therapy.

J Urol. 2019 02;201(2):284-291

Authors: Berlin A, Moraes FY, Sanmamed N, Glicksman R, Koven A, Espin-Garcia O, Leite ETT, Silva JLF, Gadia R, Nesbitt M, Catton CN, Kaffenberger S, Salami SS, Morgan TM, Hearn JWD, Jackson WC, Mehra R, Chung P, Fleshner NE, Zumsteg ZS, Dess RT, Feng FY, Finelli A, Spratt DE

Abstract
PURPOSE: The NCCN Guidelines® recently endorsed a subclassification of intermediate risk prostate cancer into favorable and unfavorable subgroups. However, this subclassification was developed in a treatment heterogeneous cohort. Thus, to our knowledge the natural history of androgen deprivation treatment naïve favorable and unfavorable intermediate risk prostate cancer cases remains unknown.
MATERIALS AND METHODS: Groups at 3 academic centers pooled data on patients with intermediate risk prostate cancer treated with radical monotherapy (dose escalated external beam radiotherapy, brachytherapy or radical prostatectomy) without combined androgen deprivation treatment. We used the cumulative incidence with competing risk analysis to estimate biochemical recurrence, distant metastasis and prostate cancer specific mortality.
RESULTS: A total of 2,550 men at intermediate risk were included in study, of whom 1,063 and 1,487 were at favorable and unfavorable risk, respectively. Of the men 1,149 underwent radical prostatectomy, 1,143 underwent dose escalated external beam radiotherapy and 258 underwent brachytherapy. Median followup after the different treatments ranged from 60.4 to 107.4 months. The 10-year cumulative incidence of distant metastasis in the favorable vs unfavorable risk groups was 0.2% (95% CI 0.2-0.2) vs 11.6% (95% CI 7.7-15.5) for radical prostatectomy (p <0.001), 2.8% (95% CI 0.8-4.8) vs 13.5% (95% CI 9.6-17.4) for dose escalated external beam radiotherapy (p <0.001) and 3.5% (95% CI 0-7.4) vs 10.2% (95% CI 4.3-16.1) for brachytherapy (p = 0.063). The 10-year rate of prostate cancer specific mortality in the favorable vs unfavorable risk groups was 0% (95% CI 0-0) vs 3.7% (95% CI 1.7-5.7) for radical prostatectomy (p = 0.016), 0.5% (95% CI 0.5-0.5) vs 5.6% (95% CI 3.6-7.6) for dose escalated external beam radiotherapy (p = 0.015) and 0% (95% CI 0-0) vs 2.5% (95% CI 0.5-4.5) for brachytherapy (p = 0.028).
CONCLUSIONS: This multicenter international effort independently validates the prognostic value of the intermediate risk prostate cancer subclassification in androgen deprivation treatment naïve cases across all radical treatment modalities. It is unlikely that treatment intensification would meaningfully improve oncologic outcomes in men at favorable intermediate risk.

PMID: 30153435 [PubMed - indexed for MEDLINE]