Sebastien Crouzet1, Andreas Blana2, Francois J Murat3, Gilles Pasticier4, Stephen C W Brown5, Giario N Conti6, Roman Ganzer7, Olivier Chapet8, Albert Gelet1, Christian G Chaussy7, Cary N Robertson9, Stefan Thuroff10, John F Ward11. 1. Department of Urology, Edouard Herriot Hospital, Lyon, France. 2. Department of Urology, Fuerth Hospital, Fürth, Germany. 3. Urology Department, Val d'Ouest Hospital, Ecully, France. 4. Department of Urology, CHU Pellegrin, Bordeaux, France. 5. Department of Urology, Stepping Hill Hospital, Stockport, UK. 6. Department of Urology, St. Anna Hospital, Como, Italy. 7. Department of Urology, University of Regensburg, Regensburg, Germany. 8. Department of Radiation Oncology, Lyon Sud Hospital, Pierre Bénite, France. 9. Department of Urology, Duke University, Durham, NC, USA. 10. Department of Urology, Harlaching Hospital, Munich, Germany. 11. Department of Urology, M. D. Anderson Cancer Center, Houston, TX, USA.
Abstract
OBJECTIVE: To report the oncological outcome of salvage high-intensity focused ultrasound (S-HIFU) for locally recurrent prostate cancer after external beam radiotherapy (EBRT) from a multicentre database. PATIENTS AND METHODS: This retrospective study comprises patients from nine centres with local recurrent disease after EBRT treated with S-HIFU from 1995 to 2009. The biochemical failure-free survival (bFFS) rate was based on the 'Phoenix' definition (PSA nadir + 2 ng/mL). Secondary endpoints included progression to metastasis and cancer-specific death. Kaplan-Meier analysis was performed examining overall (OS), cancer-specific (CSS) and metastasis-free survival (MFS). Adverse events and quality of life status are reported. RESULTS: In all, 418 patients with a mean (SD) follow-up of 3.5 (2.5) years were included. The mean (SD) age was 68.6 (5.8) years and the PSA level before S-HIFU was 6.8 (7.8) ng/mL. The median PSA nadir after S-HIFU was 0.19 ng/mL. The OS, CSS and MFS rates at 7 years were 72%, 82% and 81%, respectively. At 5 years the bFFS rate was 58%, 51% and 36% for pre-EBRT low-, intermediate- and high-risk patients, respectively. The 5-year bFFS rate was 67%, 42% and 22% for pre-S-HIFU PSA level ≤4, 4-10 and ≥10 ng/mL, respectively. Complication rates decreased after the introduction of specific post-RT parameters: incontinence (grade II or III) from 32% to 19% (P = 0.002); bladder outlet obstruction or stenosis from 30% to 15% (P = 0.003); recto-urethral fistula decreased from 9% to 0.6% (P < 0.001). Study limitations include being a retrospective analysis from a registry with no control group. CONCLUSION: S-HIFU for locally recurrent prostate cancer after failed EBRT is associated with 7-year CSS and MFS rates of >80% at a price of significant morbidity. S-HIFU should be initiated early following EBRT failure.
OBJECTIVE: To report the oncological outcome of salvage high-intensity focused ultrasound (S-HIFU) for locally recurrent prostate cancer after external beam radiotherapy (EBRT) from a multicentre database. PATIENTS AND METHODS: This retrospective study comprises patients from nine centres with local recurrent disease after EBRT treated with S-HIFU from 1995 to 2009. The biochemical failure-free survival (bFFS) rate was based on the 'Phoenix' definition (PSA nadir + 2 ng/mL). Secondary endpoints included progression to metastasis and cancer-specific death. Kaplan-Meier analysis was performed examining overall (OS), cancer-specific (CSS) and metastasis-free survival (MFS). Adverse events and quality of life status are reported. RESULTS: In all, 418 patients with a mean (SD) follow-up of 3.5 (2.5) years were included. The mean (SD) age was 68.6 (5.8) years and the PSA level before S-HIFU was 6.8 (7.8) ng/mL. The median PSA nadir after S-HIFU was 0.19 ng/mL. The OS, CSS and MFS rates at 7 years were 72%, 82% and 81%, respectively. At 5 years the bFFS rate was 58%, 51% and 36% for pre-EBRT low-, intermediate- and high-risk patients, respectively. The 5-year bFFS rate was 67%, 42% and 22% for pre-S-HIFU PSA level ≤4, 4-10 and ≥10 ng/mL, respectively. Complication rates decreased after the introduction of specific post-RT parameters: incontinence (grade II or III) from 32% to 19% (P = 0.002); bladder outlet obstruction or stenosis from 30% to 15% (P = 0.003); recto-urethral fistula decreased from 9% to 0.6% (P < 0.001). Study limitations include being a retrospective analysis from a registry with no control group. CONCLUSION: S-HIFU for locally recurrent prostate cancer after failed EBRT is associated with 7-year CSS and MFS rates of >80% at a price of significant morbidity. S-HIFU should be initiated early following EBRT failure.
Authors: H Petra Kok; Erik N K Cressman; Wim Ceelen; Christopher L Brace; Robert Ivkov; Holger Grüll; Gail Ter Haar; Peter Wust; Johannes Crezee Journal: Int J Hyperthermia Date: 2020 Impact factor: 3.914
Authors: Juanita Crook; Joseph P Rodgers; Thomas M Pisansky; Edouard J Trabulsi; Mahul B Amin; William Bice; Gerard Morton; Albert D Murtha; Eric Vigneault; Joelle Helou; Jeff M Michalski; Mack Roach; David Beyer; Ashesh B Jani; Eric M Horwitz; Adam Raben; Stephanie Pugh; Howard Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2021-11-03 Impact factor: 7.038
Authors: Brecht Devos; Walid Al Hajj Obeid; Colin Andrianne; Romain Diamand; Alexandre Peltier; Wouter Everaerts; Hein Van Poppel; Roland Van Velthoven; Steven Joniau Journal: World J Urol Date: 2019-01-21 Impact factor: 4.226
Authors: Soleen Ghafoor; Daniel Stocker; Olivio F Donati; Hebert Alberto Vargas; Anton S Becker; Borna K Barth; Daniel Eberli Journal: Abdom Radiol (NY) Date: 2020-11
Authors: Shawn Dason; Nathan C Wong; Christopher B Allard; Jen Hoogenes; William Orovan; Bobby Shayegan Journal: Int Braz J Urol Date: 2018 Mar-Apr Impact factor: 1.541