BACKGROUND: In selected patients with unilateral, organ-confined prostate cancer (PCa), hemiablation of the affected lobe might be feasible to achieve acceptable cancer control with fewer complications. OBJECTIVES: To assess the oncologic and functional outcomes of focal high-intensity focused ultrasound (HIFU) hemiablation in unilateral organ-confined PCa. DESIGN, SETTING AND PATIENTS: Single-center prospective evaluation of HIFU hemiablation for unilateral organ-confined PCa was performed from July 2009 through December 2013. INTERVENTION: Cancer localization was done with transrectal ultrasound-guided biopsy and multiparametric magnetic resonance imaging followed by HIFU hemiablation. OUTCOME MEASUREMENT AND STATISTICAL ANALYSIS: Oncologic outcomes were analyzed with control biopsies and prostate-specific antigen (PSA) measurement. Functional outcomes were assessed with validated questionnaires for genitourinary symptoms. RESULTS AND LIMITATIONS: Of 71 HIFU hemiablation patients, 67 completed the study protocol. The mean age was 70.2 yr (standard deviation: 6.8 yr), and median PSA was 6.1 ng/ml (interquartile range [IQR]: 1.6-15.5 ng/ml). Median maximum cancer-core length was 3 mm (IQR: 2-10 mm), and total cancer length was 6.5 mm (IQR: 2-24 mm). Gleason score was 6 (3+3) in 58 patients (86.6%) and 7 (3+4) in 9 patients (13.4%). Median follow-up was 12 mo (IQR: 6-50 mo), and at 12 mo, 56 of 67 patients had a negative control biopsy in the treated lobe. At 3 mo, all patients were continent, and potency was maintained in 11 of 21 preoperatively potent patients (confidence interval, 0.18-0.69). Complications included 8% Clavien-Dindo grade 2 and 2.8% grade 3 events. CONCLUSIONS: Focal HIFU hemiablation appears to achieve acceptable oncologic outcomes with low morbidity and minimal functional changes. Longer follow-up will establish future considerations. PATIENT SUMMARY: This study showed that high-intensity focused ultrasound hemiablation in selected patients with unilateral organ-confined prostate cancer can be used for satisfactory cancer control with minimal effect on genitourinary functions.
BACKGROUND: In selected patients with unilateral, organ-confined prostate cancer (PCa), hemiablation of the affected lobe might be feasible to achieve acceptable cancer control with fewer complications. OBJECTIVES: To assess the oncologic and functional outcomes of focal high-intensity focused ultrasound (HIFU) hemiablation in unilateral organ-confined PCa. DESIGN, SETTING AND PATIENTS: Single-center prospective evaluation of HIFU hemiablation for unilateral organ-confined PCa was performed from July 2009 through December 2013. INTERVENTION: Cancer localization was done with transrectal ultrasound-guided biopsy and multiparametric magnetic resonance imaging followed by HIFU hemiablation. OUTCOME MEASUREMENT AND STATISTICAL ANALYSIS: Oncologic outcomes were analyzed with control biopsies and prostate-specific antigen (PSA) measurement. Functional outcomes were assessed with validated questionnaires for genitourinary symptoms. RESULTS AND LIMITATIONS: Of 71 HIFU hemiablation patients, 67 completed the study protocol. The mean age was 70.2 yr (standard deviation: 6.8 yr), and median PSA was 6.1 ng/ml (interquartile range [IQR]: 1.6-15.5 ng/ml). Median maximum cancer-core length was 3 mm (IQR: 2-10 mm), and total cancer length was 6.5 mm (IQR: 2-24 mm). Gleason score was 6 (3+3) in 58 patients (86.6%) and 7 (3+4) in 9 patients (13.4%). Median follow-up was 12 mo (IQR: 6-50 mo), and at 12 mo, 56 of 67 patients had a negative control biopsy in the treated lobe. At 3 mo, all patients were continent, and potency was maintained in 11 of 21 preoperatively potent patients (confidence interval, 0.18-0.69). Complications included 8% Clavien-Dindo grade 2 and 2.8% grade 3 events. CONCLUSIONS: Focal HIFU hemiablation appears to achieve acceptable oncologic outcomes with low morbidity and minimal functional changes. Longer follow-up will establish future considerations. PATIENT SUMMARY: This study showed that high-intensity focused ultrasound hemiablation in selected patients with unilateral organ-confined prostate cancer can be used for satisfactory cancer control with minimal effect on genitourinary functions.
Authors: David Bonekamp; M B Wolf; M C Roethke; S Pahernik; B A Hadaschik; G Hatiboglu; T H Kuru; I V Popeneciu; J L Chin; M Billia; J Relle; J Hafron; K R Nandalur; R M Staruch; M Burtnyk; M Hohenfellner; H-P Schlemmer Journal: Eur Radiol Date: 2018-06-25 Impact factor: 5.315
Authors: R Ganzer; T Franiel; J Köllermann; T Kuru; D Baumunk; A Blana; B Hadaschik; J von Hardenberg; T Henkel; K-U Köhrmann; U-B Liehr; S Machtens; A Roosen; G Salomon; H-P Schlemmer; L Sentker; J Wendler; U Witzsch; M Schostak Journal: Urologe A Date: 2017-10 Impact factor: 0.639
Authors: Behfar Ehdaie; Clare M Tempany; Ford Holland; Daniel D Sjoberg; Adam S Kibel; Quoc-Dien Trinh; Jeremy C Durack; Oguz Akin; Andrew J Vickers; Peter T Scardino; Dan Sperling; Jeffrey Y C Wong; Bertram Yuh; David A Woodrum; Lance A Mynderse; Steven S Raman; Allan J Pantuck; Marc H Schiffman; Timothy D McClure; Geoffrey A Sonn; Pejman Ghanouni Journal: Lancet Oncol Date: 2022-06-14 Impact factor: 54.433
Authors: Jonathan B Bloom; Samuel A Gold; Graham R Hale; Kareem N Rayn; Vikram K Sabarwal; Ivane Bakhutashvili; Vladimir Valera; Baris Turkbey; Peter A Pinto; Bradford J Wood Journal: Gland Surg Date: 2018-04
Authors: Steve R Zhou; Alan M Priester; Rajiv Jayadevan; David C Johnson; Jason J Yang; Jorge Ballon; Shyam Natarajan; Leonard S Marks Journal: BJU Int Date: 2019-11-25 Impact factor: 5.969