Prospective Evaluation of Focal High Intensity Focused Ultrasound for Localized Prostate Cancer

No AccessJournal of UrologyAdult Urology1 Sep 2020Prospective Evaluation of Focal High Intensity Focused Ultrasound for Localized Prostate CancerThis article is commented on by the following:Editorial Comment Bruno Nahar, Abhishek Bhat, Isildinha M. Reis, Nachiketh Soodana-Prakash, Maria F. Becerra, Diana Lopategui, Vivek Venkatramani, Ronak Patel, Vinayak Madhusoodanan, Oleksandr N. Kryvenko, Chad R. Ritch, Mark L. Gonzalgo, Sanoj Punnen, and Dipen J. Parekh Bruno NaharBruno Nahar Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author , Abhishek BhatAbhishek Bhat Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Isildinha M. ReisIsildinha M. Reis Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida Sylvester Biostatistics and Bioinformatics Shared Resource, University of Miami, Miami, Florida More articles by this author , Nachiketh Soodana-PrakashNachiketh Soodana-Prakash Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Maria F. BecerraMaria F. Becerra Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Diana LopateguiDiana Lopategui Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Vivek VenkatramaniVivek Venkatramani Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Ronak PatelRonak Patel Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Vinayak MadhusoodananVinayak Madhusoodanan Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Oleksandr N. KryvenkoOleksandr N. Kryvenko Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida More articles by this author , Chad R. RitchChad R. Ritch Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author , Mark L. GonzalgoMark L. Gonzalgo Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author , Sanoj PunnenSanoj Punnen Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author , and Dipen J. ParekhDipen J. Parekh *Correspondence: Department of Urology, University of Miami, Miller School of Medicine, 1120 NW 14th St., Suite 1551S, Miami, Florida 33136 E-mail Address: [email protected] Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001015AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We report short-term outcomes of focal high intensity focused ultrasound use for primary treatment of localized prostate cancer. Materials and Methods: Single-center prospectively collected data on patients with prostate cancer who underwent primary focal high intensity focused ultrasound from January 2016 to July 2018 were included. All patients underwent a 12-core biopsy with magnetic resonance imaging-ultrasound fusion biopsy depending on the presence of targetable lesions. Any Grade Group was allowed, however only patients with localized disease were included. The primary outcome was oncologic control, defined as negative followup in-field biopsy of treated cancer. Prostate specific antigen, Sexual Health Inventory for Men, International Prostate Symptom Score and Expanded Prostate Cancer Index Composite domain scores were assessed 3-monthly till 12 months. Biopsy was performed at 6 or 12 months for high or low/intermediate risk cancer, respectively. Results: Fifty-two patients with minimum followup of 12 months were included in the study. The majority of patients (67%) had cancer Grade Group 2 or greater. Fifteen patients (28.8%) underwent complete transurethral prostate resection/holmium laser enucleation of prostate procedure for debulking large prostates to avoid postoperative urinary retention. Among 30 (58%) patients who underwent followup biopsies, 25 (83%) had negative in-field biopsy results and 4 (13%) had de-novo positive out-of-field biopsy. Only 5 major complications (all grade III) in 4 patients were noted. Urinary symptoms returned to near baseline questionnaire scores within 3-6 months. Sexual function returned to baseline at 12 months. Conclusions: Focal high intensity focused ultrasound is a safe and effective treatment for patients with localized clinically significant prostate cancer with acceptable short-term oncologic and functional outcomes. The complications are minimal and patient selection is essential. Short-term oncologic outcomes are promising but longer followup is required to establish long-term oncologic outcomes. References 1. : Cancer statistics, 2018. CA Cancer J Clin 2018; 68: 7. Google Scholar 2. : Focal ablation targeted to the index lesion in multifocal localised prostate cancer: a prospective development study. Eur Urol 2015; 68: 927. 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Google Scholar No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byRompré-Brodeur A, Marcq G, Tholomier C, Fugaru I, Loutochin O, Anidjar M and Bladou F (2021) Role of Systematic Control Biopsies following Partial Gland Ablation with High-Intensity Focused Ultrasound for Clinically Significant Prostate CancerJournal of Urology, VOL. 206, NO. 5, (1177-1183), Online publication date: 1-Nov-2021.Nahar B (2021) Editorial CommentJournal of Urology, VOL. 206, NO. 3, (645-645), Online publication date: 1-Sep-2021.Smith J (2020) This Month in Adult UrologyJournal of Urology, VOL. 204, NO. 3, (403-405), Online publication date: 1-Sep-2020.Related articlesJournal of Urology26 Jun 2020Editorial Comment Volume 204Issue 3September 2020Page: 483-489 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.Keywordstreatment outcomeprostatic neoplasmsultrasoundMetricsAuthor Information Bruno Nahar Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author Abhishek Bhat Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Isildinha M. Reis Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida Sylvester Biostatistics and Bioinformatics Shared Resource, University of Miami, Miami, Florida More articles by this author Nachiketh Soodana-Prakash Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Maria F. Becerra Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Diana Lopategui Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Vivek Venkatramani Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Ronak Patel Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Vinayak Madhusoodanan Department of Urology, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Oleksandr N. Kryvenko Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida More articles by this author Chad R. Ritch Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author Mark L. Gonzalgo Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author Sanoj Punnen Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida More articles by this author Dipen J. Parekh Department of Urology, University of Miami Miller School of Medicine, Miami, Florida Sylvester Comprehensive Cancer Center, University of Miami, Miami, Florida *Correspondence: Department of Urology, University of Miami, Miller School of Medicine, 1120 NW 14th St., Suite 1551S, Miami, Florida 33136 E-mail Address: [email protected] More articles by this author Expand All No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. Advertisement PDF downloadLoading ...