Oncological and functional outcome after partial prostate HIFU ablation with Focal-One®: a prospective single-center study

Dellabella, Marco; Branchi, Alessandro; Rosa, Mirko Di; Pucci, Michele; Gasparri, Luca; Claudini, Redi; Carnevali, Francesca; Cecchini, Silvia; Castellani, Daniele

doi:10.1038/s41391-021-00390-9

Cited by 17 publications

(19 citation statements)

References 34 publications

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“…The series by Ganzer et al also demonstrated limited sensitivity of posttreatment MRI for clinically significant prostate cancer [ 24 ]. Dellabella et al identified 38.4% of their patients having prostate cancer on 1-year biopsy, of whom 61.8% of patients went on for another line of treatment [ 25 ]. Further study is warranted to investigate the role of routine biopsy in evaluating recurrence after focal therapy for prostate cancer.…”

Section: Discussionmentioning

confidence: 99%

High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform

Yee

Chiu

Teoh

et al. 2021

Advances in Urology

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Objective. The study aimed at investigating the outcome of prostate HIFU focal therapy using the MRI-US fusion platform for treatment localization and delivery. Methods. It is a prospectively designed case series of HIFU focal therapy for localized prostate cancer. The inclusion criteria include clinical tumor stage ≤T2, visible index lesion on multiparametric MRI less than 20 mm in diameter, absence of Gleason 5 pattern on prostate biopsy, and PSA ≤ 20 ng/ml. HIFU focal therapy was performed in the conventional manner in the beginning 50% of the series, whereas the subsequent cases were performed with MRI-US fusion platform. The primary outcome was treatment failure rate which is defined by the need of salvage therapy. Secondary outcomes included tumor recurrence in follow-up biopsy, PSA change, perioperative complications, and postoperative functional outcomes. Results. Twenty patients underwent HIFU focal ablation. HIFU on an MRI-US fusion platform had a trend of a longer total operative time than the conventional counterpart (124.2 min vs. 107.1 min, p = 0.066 ). There was no difference in the mean ablation volume to lesion volume ratio between the two. The mean PSA percentage change from baseline to 6-month is more significant in the conventional group (63.3% vs. 44.6%, p = 0.035 ). No suspicious lesion was seen at 6-month mpMRI in all 20 patients. Two patients, one from each group, eventually underwent radical treatment because of the presence of clinically significant prostate cancer in the form of out-of-field recurrences during follow-up biopsy. No significant difference was observed before and after HIFU concerning uroflowmetry, SF-12 score, and EPIC-26 score. It was observed that energy used per volume was positively correlated with PSA density of the patient (r = 0.6364, p = 0.014 ). Conclusion. In conclusion, HIFU with conventional or MRI-US fusion platform provided similar oncological and functional outcomes.

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Section: Discussionmentioning

confidence: 99%

High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform

Yee

Chiu

Teoh

et al. 2021

Advances in Urology

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“…Table 2 11,19,[26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] shows a summary of the reports in which ≥50 patients were treated by FT using HIFU in the 5-year period. We identified 20 studies with 50-1032 patients included.…”

Section: High-intensity Focused Ultrasoundmentioning

confidence: 99%

“…Regarding oncological outcome, the transition of FT to whole-gland/radical/systematic treatment was 1.9% to 19.6%. 11,19,26,27,29,30,32,[35][36][37][39][40][41]43 The largest study presented 39 included 1032 patients and the freedom from whole-gland/radical/systematic treatment at 12, 24, 60, and 96 months was 100%, 98%, 91%, and 81%, respectively. Some of the studies reported the rate of free from "Treatment failure (in-field or out-of-field CSCa on follow-up-prostate biopsy, conversion to whole-gland/radical or systemic treatment, occurrence of metastasis or cancer specific mortality)."…”

Section: High-intensity Focused Ultrasoundmentioning

confidence: 99%

Focal therapy of localized prostate cancer

Fujihara

Ukimura

2022

Int J of Urology

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In the treatment of localized prostate cancer, controlling the cancer and maintaining quality of life are important. Focal therapy of localized prostate cancer aims to treat the lesion/part of the prostate that includes the index lesion, which determines the prognosis. We performed a non‐systematic review of novel studies on focal therapy of localized prostate cancer as primary treatment published between 2016 and 2021. For mainly intermediate‐risk patients, therapeutic technology, such as cryoablation, brachytherapy, high‐intensity focused ultrasound, photodynamic therapy, microwave‐coagulation, electroporation, and laser ablation, etc., were performed. These procedures are minimally invasive and safe, and provide good functional outcome: a 94–100% pad‐free rate against urinary incontinence and 47–86% erectile function, which is sufficient for sexual intercourse. Accurate three‐dimensional mapping of the targeted lesion could be an essential navigation technique for therapeutic success. Intermediate‐ to short‐term oncological outcomes were good, resulting in downstaging of the patient's status to no clinically significant cancer; however, transition to conventional whole‐gland treatment was necessary in about 10–30% of patients. It is important to select appropriate patients by both multiparametric magnetic resonance imaging and targeted biopsy, and to follow‐up postoperatively with methods such as active surveillance. Clinically significant prostate‐specific antigen reduction, image response using preoperative and postoperative multiparametric magnetic resonance imaging, and histological analysis should be combined for follow‐up.

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“…Importantly, there are several caveats when using HIFU. These include lack of treatment of all cancerous lesions, inadequate ablation of anterior tumors, 125 lack of standardization of how to follow these patients, 126 and to-date, lacking long-term follow-up data. 127…”

Section: Trus For Focal Therapy Of Prostate Cancermentioning

confidence: 99%

Transrectal Ultrasound in Prostate Cancer: Current Utilization, Integration with mpMRI, HIFU and Other Emerging Applications

Panzone¹,

Byler²,

Bratslavsky³

et al. 2022

CMAR

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Oncological and functional outcome after partial prostate HIFU ablation with Focal-One®: a prospective single-center study

Cited by 17 publications

References 34 publications

High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform

High-Intensity Focused Ultrasound (HIFU) Focal Therapy for Localized Prostate Cancer with MRI-US Fusion Platform

Focal therapy of localized prostate cancer

Transrectal Ultrasound in Prostate Cancer: Current Utilization, Integration with mpMRI, HIFU and Other Emerging Applications

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