BACKGROUND: The aim of this study was to evaluate oncologic outcomes and adverse events for patients with prostate cancer after treatment by high-intensity focused ultrasound (HIFU). METHODS: Between February 2004 and August 2010, patients with prostate cancer who underwent HIFU treatment were reviewed about oncologic outcomes and complications. Biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) nadir plus 1.2 ng/ml. Kaplan-Meier analysis was performed to evaluate BCR- and disease progression-free survival according to risk stratification. Predictors for BCR and disease progression were identified using the Cox-proportional hazard method. RESULTS: The overall BCR rate was 59.5%, and median time to BCR was 13.8 months. The 5-year BCR-free survival rates of the low-, intermediate-, and high-risk groups were 66.3, 40.2, and 21.0% (P = 0.001), respectively, and the 5-year disease progression-free survival rates were 73.5, 46.0, and 29.2%, respectively (P = 0.008). Multivariate analysis showed that risk stratification, PSA nadir, and time to PSA nadir were significant predictors of BCR and disease progression. In the first 3 months post-op, 11 patients (8.7%) had complications. There were no patients who required blood transfusions or who had wound problems, stroke, deep vein thrombosis, or bowel dysfunction. CONCLUSIONS: HIFU treatment does not provide effective oncologic outcomes even in low risk patients with prostate cancer as well as in the intermediate or high risk groups. Therefore, patients selected to undergo HIFU treatment for prostate cancer must be very carefully chosen. On the other hand, HIFU treatment for prostate cancer had a very low rate of complications.
BACKGROUND: The aim of this study was to evaluate oncologic outcomes and adverse events for patients with prostate cancer after treatment by high-intensity focused ultrasound (HIFU). METHODS: Between February 2004 and August 2010, patients with prostate cancer who underwent HIFU treatment were reviewed about oncologic outcomes and complications. Biochemical recurrence (BCR) was defined as prostate-specific antigen (PSA) nadir plus 1.2 ng/ml. Kaplan-Meier analysis was performed to evaluate BCR- and disease progression-free survival according to risk stratification. Predictors for BCR and disease progression were identified using the Cox-proportional hazard method. RESULTS: The overall BCR rate was 59.5%, and median time to BCR was 13.8 months. The 5-year BCR-free survival rates of the low-, intermediate-, and high-risk groups were 66.3, 40.2, and 21.0% (P = 0.001), respectively, and the 5-year disease progression-free survival rates were 73.5, 46.0, and 29.2%, respectively (P = 0.008). Multivariate analysis showed that risk stratification, PSA nadir, and time to PSA nadir were significant predictors of BCR and disease progression. In the first 3 months post-op, 11 patients (8.7%) had complications. There were no patients who required blood transfusions or who had wound problems, stroke, deep vein thrombosis, or bowel dysfunction. CONCLUSIONS: HIFU treatment does not provide effective oncologic outcomes even in low risk patients with prostate cancer as well as in the intermediate or high risk groups. Therefore, patients selected to undergo HIFU treatment for prostate cancer must be very carefully chosen. On the other hand, HIFU treatment for prostate cancer had a very low rate of complications.
Authors: Wan Song; U Seok Jung; Yoon Seok Suh; Hyun Jun Jang; Hyun Hwan Sung; Hwang Gyun Jeon; Byung Chang Jeong; Seong Il Seo; Seong Soo Jeon; Han Yong Choi; Hyun Moo Lee Journal: Korean J Urol Date: 2014-02-14