Sunao Shoji1,2, Shinichiro Hiraiwa3, Kohei Uemura4, Masahiro Nitta5, Masanori Hasegawa5, Yoshiaki Kawamura5, Kazunobu Hashida6, Terumitsu Hasebe6, Takuma Tajiri3, Akira Miyajima5. 1. Departments of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. sunashoj@mail.goo.ne.jp. 2. Department of Urology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan. sunashoj@mail.goo.ne.jp. 3. Department of Pathology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan. 4. Biostatistics and Bioinformatics Course, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8654, Japan. 5. Departments of Urology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. 6. Department of Radiology, Tokai University Hachioji Hospital, 1838 Ishikawa-machi, Hachioji, Tokyo, 192-0032, Japan.
Abstract
BACKGROUND: We evaluated clinical outcomes of region target focal therapy with high-intensity focused ultrasound (HIFU) for the localized prostate cancer (PCa) based on magnetic resonance imaging-based biopsy and systematic prostate biopsy for Asian. METHODS: We prospectively recruited patients with localized PCa, located their significant tumors using MRI-transrectal ultrasound (TRUS) elastic fusion image-guided transperineal prostate biopsy and 12-cores transperineal systematic biopsy, and focally treated these regions in which the tumors were located in the prostate using HIFU. Patients' functional and oncological outcomes were analyzed prospectively. RESULTS: We treated 90 men (median age 70 years; median PSA level 7.26 ng/ml). Catheterization was performed within 24 h after the treatment in all patients. Biochemical disease-free rate was 92.2% during 21 months follow-up when use of Phoenix ASTRO definition. In follow-up biopsy, significant cancer was detected in 8.9% of the patients in un-treated areas. Urinary functions, including international prostate symptom score (IPSS) (P < 0.0001), IPSS quality of life (QOL) (P = 0.001), overactive bladder symptom score (OABSS) (P < 0.0001), EPIC urinary domain (P < 0.0001), maximum urinary flow rate (P < 0.0001), and IIEF-5 (P = 0.001), had significantly deteriorated at 1 month after treatment, but improved to preoperative levels at 3 or 6 months. Rates of erectile dysfunction and ejaculation who had the functions were 86% and 70%, respectively, at 12 months after treatment. CONCLUSIONS: The present treatment for Asian would have similar oncological and functional outcomes to those in previous reports. Further large studies are required to verify oncological and functional outcomes from this treatment for patients with localized PCa.
BACKGROUND: We evaluated clinical outcomes of region target focal therapy with high-intensity focused ultrasound (HIFU) for the localized prostate cancer (PCa) based on magnetic resonance imaging-based biopsy and systematic prostate biopsy for Asian. METHODS: We prospectively recruited patients with localized PCa, located their significant tumors using MRI-transrectal ultrasound (TRUS) elastic fusion image-guided transperineal prostate biopsy and 12-cores transperineal systematic biopsy, and focally treated these regions in which the tumors were located in the prostate using HIFU. Patients' functional and oncological outcomes were analyzed prospectively. RESULTS: We treated 90 men (median age 70 years; median PSA level 7.26 ng/ml). Catheterization was performed within 24 h after the treatment in all patients. Biochemical disease-free rate was 92.2% during 21 months follow-up when use of Phoenix ASTRO definition. In follow-up biopsy, significant cancer was detected in 8.9% of the patients in un-treated areas. Urinary functions, including international prostate symptom score (IPSS) (P < 0.0001), IPSS quality of life (QOL) (P = 0.001), overactive bladder symptom score (OABSS) (P < 0.0001), EPIC urinary domain (P < 0.0001), maximum urinary flow rate (P < 0.0001), and IIEF-5 (P = 0.001), had significantly deteriorated at 1 month after treatment, but improved to preoperative levels at 3 or 6 months. Rates of erectile dysfunction and ejaculation who had the functions were 86% and 70%, respectively, at 12 months after treatment. CONCLUSIONS: The present treatment for Asian would have similar oncological and functional outcomes to those in previous reports. Further large studies are required to verify oncological and functional outcomes from this treatment for patients with localized PCa.
Entities:
Keywords:
Cancer control; Focal therapy; High-intensity focused ultrasound; Localized prostate cancer; Magnetic resonance imaging; Quality of life
Authors: John R Heard; Aurash Naser-Tavakolian; Michael Nazmifar; Michael Ahdoot Journal: Prostate Cancer Prostatic Dis Date: 2022-03-04 Impact factor: 5.455