Comparing High-Intensity Focal Ultrasound Hemiablation to Robotic Radical Prostatectomy in the Management of Unilateral Prostate Cancer: A Matched-Pair Analysis

Albisinni, Simone; Aoun, Fouad; Bellucci, Simon; Biaou, Ibrahim; Limani, Ksenija; Hawaux, Eric; Peltier, Alexandre; Velthoven, Roland Van

doi:10.1089/end.2016.0702

Cited by 43 publications

(53 citation statements)

References 23 publications

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“…In other studies, 5‐year biochemical recurrence‐free survival rate in radical prostatectomy was 55.2%, 7‐year biochemical recurrence‐free survival rate in brachytherapy was 66% (with boost) versus 48% (without boost) in high‐risk patients . Although long‐term follow‐up data are not currently available, the oncological control in HIFU patients seems not significantly inferior to others, but shows better functional outcomes . We suggest that HIFU treatment can still be used in selective high‐risk patients.…”

Section: Discussionmentioning

confidence: 57%

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Primary whole‐gland ablation for localized prostate cancer with high‐intensity focused ultrasound: The important predictors of biochemical recurrence

et al. 2018

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Postoperative prostate-specific antigen nadir of 0.43 ng/mL can be considered an important predictive factor for biochemical recurrence in primary whole-prostate gland high-intensity focused ultrasound treatment, and the nadir-related prediction model might provide a reference for early salvage treatment. Furthermore, Gleason score ≥7, stage ≥T2b might be associated with unfavorable outcomes, although prostate volume and higher initial prostate-specific antigen appear not to be associated with biochemical recurrence for the high-intensity focused ultrasound treatment.

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Section: Discussionmentioning

confidence: 57%

“…25 Although long-term follow-up data are not currently available, the oncological control in HIFU patients seems not significantly inferior to others, but shows better functional outcomes. [26][27][28] We suggest that HIFU treatment can still be used in selective high-risk patients.…”

Section: Discussionmentioning

confidence: 98%

Primary whole‐gland ablation for localized prostate cancer with high‐intensity focused ultrasound: The important predictors of biochemical recurrence

et al. 2018

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“…[11][12][13][14][15][16][17] Third, the 4 studies reporting oncologic outcomes after hemiablation reported that repeat TRUS biopsy identified contralateral CaP in approximately 10% to 22% of patients. [31][32][33][34] In a similar baseline patient population, contralateral CaP was detected in 65% to 79% of prostatectomy specimens. [11][12][13][14][15][16][17]33 This finding highlights the potential for biopsy sampling error to overestimate the true efficacy of hemiablation, a shortcoming that we avoided by using WMP as the reference standard.…”

Section: Discussionmentioning

confidence: 91%

Do contemporary imaging and biopsy techniques reliably identify unilateral prostate cancer? Implications for hemiablation patient selection

Johnson

Yang

Kwan

et al. 2019

Cancer

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BACKGROUND: Hemiablation is a less morbid treatment alternative for appropriately selected patients with unilateral prostate cancer (PCa). However, to the authors' knowledge, traditional diagnostic techniques inadequately identify appropriate candidates. In the current study, the authors quantified the accuracy for identifying hemiablation candidates using contemporary diagnostic techniques, including multiparametric magnetic resonance imaging (mpMRI) and MRI-fusion with complete systematic template biopsy. METHODS: A retrospective analysis of patients undergoing MRI and MRI-fusion prostate biopsy, including full systematic template biopsy, prior to radical prostatectomy in a single tertiary academic institution between June 2010 and February 2018 was performed. Hemiablation candidates had unilateral intermediate-risk PCa (Gleason score [GS] of 3+4 or 4+3, clinical T classification ≤T2, and prostate-specific antigen level <20 ng/dL) on MRI-fusion biopsy and 2) no contralateral highly or very highly suspicious Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) MRI lesions. Hemiablation candidates were inappropriately selected if pathologists identified contralateral GS ≥3+4 or high-risk ipsilateral PCa on prostatectomy. The authors tested a range of hemiablation inclusion criteria and performed multivariable analysis of preoperative predictors of undetected contralateral disease. RESULTS: Of 665 patients, 92 met primary hemiablation criteria. Of these 92 patients, 44 (48%) were incorrectly identified due to ipsilateral GS ≥3+4 tumors crossing the midline (21 patients), undetected distinct contralateral GS ≥3+4 tumors (20 patients), and/ or ipsilateral high-risk PCa (3 patients) on prostatectomy. The rate of undetected contralateral disease ranged from 41% to 48% depending on inclusion criteria. On multivariable analysis, men with anterior index tumors were found to be 2.4 times more likely to harbor undetected contralateral GS ≥3+4 PCa compared with men with posterior lesions (P < .05). CONCLUSIONS: Clinicians and patients must weigh the risk of inadequate oncologic treatment against the functional benefits of hemiablation. Further investigation into methods for improving patient selection for hemiablation is necessary. Cancer 2019;125:2955-2964.

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“…Currently, mechanical HIFU technology, as applied to prostate ablation, is predominately at the phase of preclinical animal studies . In the very first study in humans, prostate hypertrophy was treated by the cavitation histotripsy technique in 25 patients with an extracorporeal HIFU device (Vortx Rx [Histosonics, Inc, Ann Arbor, MI]) .…”

Section: Thermal Versus Mechanical Hifumentioning

confidence: 99%

Histotripsy: The Next Generation of High‐Intensity Focused Ultrasound for Focal Prostate Cancer Therapy

Dubinsky

Khokhlova

et al. 2019

J of Ultrasound Medicine

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This article reviews the most current methods and technological aspects of highintensity focused ultrasound (HIFU), which is termed histotripsy. The rationale for focal therapy for prostate carcinoma rather than prostatectomy, which is being used extensively throughout Europe and Asia, is presented, and an argument for why HIFU is the modality of choice for primary therapy and recurrent disease is offered. The article presents a review of the technical advances including higher ultrasound beam energy than current thermal HIFU which allows for more accurate tissue targeting, less collateral tissue damage, and faster treatment times. Finally, the article presents a discussion about the advantage of ultrasound guidance for histotripsy in preference to magnetic resonance imaging guidance primarily based on cost, ease of application, and portability.

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Comparing High-Intensity Focal Ultrasound Hemiablation to Robotic Radical Prostatectomy in the Management of Unilateral Prostate Cancer: A Matched-Pair Analysis

Cited by 43 publications

References 23 publications

Primary whole‐gland ablation for localized prostate cancer with high‐intensity focused ultrasound: The important predictors of biochemical recurrence

Primary whole‐gland ablation for localized prostate cancer with high‐intensity focused ultrasound: The important predictors of biochemical recurrence

Do contemporary imaging and biopsy techniques reliably identify unilateral prostate cancer? Implications for hemiablation patient selection

Histotripsy: The Next Generation of High‐Intensity Focused Ultrasound for Focal Prostate Cancer Therapy

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