Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer

Hatiboglu, Gencay; Popeneciu, Ionel Valentin; Deppert, M.; Nyarangi‐Dix, Joanne; Hadaschik, Boris; Hohenfellner, Markus; Teber, Doğu; Pahernik, Sascha

doi:10.1186/s12894-017-0198-2

Cited by 16 publications

(15 citation statements)

References 24 publications

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“…[ 4 , 7 , 8 , 13 ] When stratified by risk category in 9 reports, lower the BDFS was found to be associated with higher risk. [ 4 , 8 , 9 , 11 – 14 , 17 , 18 ] However, Blana et al [ 4 ] reported that the 5- and 7-year BDFS rates were 77% and 69% with no statistical difference between low- and intermediate-risk patients. The 7- and 10-year disease-free survival (DFS) rates have been reported to be 59%, [ 4 ] and 48.8%, [ 20 ] respectively.…”

Section: Resultsmentioning

confidence: 99%

“…The incidence of impotence was 30.7% to 65.6%. [ 4 , 6 , 9 , 13 , 17 , 18 , 20 ] The rates of urinary incontinence and impotency were found to be 10% (95% confidence interval [CI] 0.06–0.14, P < .00001) and 44% (95% CI 0.35–0.52, P < .00001) in the meta-analysis (Table 3 and Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…The incidences of BOO and urethral strictures have been reported to be 0.8% to 35.1% [ 7 – 9 , 12 , 20 ] and 3.6% to 19.7%, [ 4 – 7 , 10 , 13 , 19 , 20 ] respectively; the incidence of urinary obstruction has been reported as 13.6%, [ 4 ] 14.5%, [ 17 ] 15.9% [ 18 ] from 3 different studies. The rates of urinary retention and infection were 7.6% to 25% [ 5 , 7 , 18 , 19 ] and 3.9% to 13.8%, [ 4 , 7 , 10 , 19 ] respectively.…”

Section: Resultsmentioning

confidence: 99%

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The primary treatment of prostate cancer with high-intensity focused ultrasound

Tan

et al. 2020

Medicine

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Background: We systematically evaluated the evidences on oncological and functional outcomes of high-intensity focused ultrasound (HIFU) as the primary treatment for localized prostate cancer (PCa). Methods: A systematic review was used Medline, Embase, and the Cochrane Library from the inception of each database. The review analyzed the oncological and functional outcomes of HIFU in the treatment of PCa. The RevMan 5.3 software was used for quantity analysis incidence of complications. Results: Twenty-seven articles were included for analysis with a total of 7393 patients. Eighteen studies investigated the whole-gland HIFU, and the duration of follow-up ranged from 2 to 168 months. After whole-gland HIFU, the mean prostate-specific antigen (PSA) nadir was found to be 0.4 to 1.95 ng/mL and the mean time to PSA nadir was 2.4 to 5.4 months. The rate of positive biopsy after HIFU was 4.5% to 91.1%. Meta-analysis revealed the incidences of urinary incontinence, impotence, urinary obstruction, retention, and infection was 10%, 44%, 15%, 11%, 7%, respectively. Nine studies investigated partial-gland HIFU, and the duration of follow-up was 1 to 131 months. After partial-gland HIFU, the mean PSA nadir was 1.9 to 2.7 ng/mL and the mean time to PSA nadir 5.7 to 7.3 months. The rate of positive biopsy after HIFU in the treatment area was 14% to 37.5%. Meta-analysis revealed the incidences of urinary incontinence, impotence, urinary obstruction, retention, and infection was 2%, 21%, 2%, 9%, 11%, respectively. Conclusions: Early evidence suggested the partial-gland HIFU was safer than whole-gland HIFU, and they had similar oncological outcomes. More prospective randomized controlled trials of whole-gland and partial-gland HIFU for PCa was needed.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The primary treatment of prostate cancer with high-intensity focused ultrasound

Tan

et al. 2020

Medicine

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“…The pattern of differences in QoL between treatments observed, particularly for urinary and sexual function, is consistent with other recent studies of focal therapies and provides positive evidence for the construct validity of instruments selected for the PART study. 79,80 Only a main RCT can provide clear evidence of short-and long-term effects on QoL of alternative treatments, which can be judged in conjunction with reliable evidence of disease and survival results in order to inform patients' and clinicians' judgements about trade-offs and treatment choices. 15…”

Section: Trial Resultsmentioning

confidence: 99%

Partial ablation versus radical prostatectomy in intermediate-risk prostate cancer: the PART feasibility RCT

Hamdy

Elliott

Conte

et al. 2018

Health Technol Assess

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Background Prostate cancer (PCa) is the most common cancer in men in the UK. Patients with intermediate-risk, clinically localised disease are offered radical treatments such as surgery or radiotherapy, which can result in severe side effects. A number of alternative partial ablation (PA) technologies that may reduce treatment burden are available; however the comparative effectiveness of these techniques has never been evaluated in a randomised controlled trial (RCT). Objectives To assess the feasibility of a RCT of PA using high-intensity focused ultrasound (HIFU) versus radical prostatectomy (RP) for intermediate-risk PCa and to test and optimise methods of data capture. Design We carried out a prospective, multicentre, open-label feasibility study to inform the design and conduct of a future RCT, involving a QuinteT Recruitment Intervention (QRI) to understand barriers to participation. Setting Five NHS hospitals in England. Participants Men with unilateral, intermediate-risk, clinically localised PCa. Interventions Radical prostatectomy compared with HIFU. Primary outcome measure The randomisation of 80 men. Secondary outcome measures Findings of the QRI and assessment of data capture methods. Results Eighty-seven patients consented to participate by 31 March 2017 and 82 men were randomised by 4 May 2017 (41 men to the RP arm and 41 to the HIFU arm). The QRI was conducted in two iterative phases: phase I identified a number of barriers to recruitment, including organisational challenges, lack of recruiter equipoise and difficulties communicating with patients about the study, and phase II comprised the development and delivery of tailored strategies to optimise recruitment, including group training, individual feedback and ‘tips’ documents. At the time of data extraction, on 10 October 2017, treatment data were available for 71 patients. Patient characteristics were similar at baseline and the rate of return of all clinical case report forms (CRFs) was 95%; the return rate of the patient-reported outcome measures (PROMs) questionnaire pack was 90.5%. Centres with specific long-standing expertise in offering HIFU as a routine NHS treatment option had lower recruitment rates (Basingstoke and Southampton) – with University College Hospital failing to enrol any participants – than centres offering HIFU in the trial context only. Conclusions Randomisation of men to a RCT comparing PA with radical treatments of the prostate is feasible. The QRI provided insights into the complexities of recruiting to this surgical trial and has highlighted a number of key lessons that are likely to be important if the study progresses to a main trial. A full RCT comparing clinical effectiveness, cost-effectiveness and quality-of-life outcomes between radical treatments and PA is now warranted. Future work Men recruited to the feasibility study will be followed up for 36 months in accordance with the protocol. We will design a full RCT, taking into account the lessons learnt from this study. CRFs will be streamlined, and the length and frequency of PROMs and resource use diaries will be reviewed to reduce the burden on patients and research nurses and to optimise data completeness. Trial registration Current Controlled Trials ISRCTN99760303. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 22, No. 52. See the NIHR Journals Library website for further project information.

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“…Transurethral HIFU has been described, but this procedure is not performed routinely (Figure ). The literature suggests that HIFU is superior to other methods because there is less posttreatment morbidity after HIFU in comparison to the other techniques …”

mentioning

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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Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer

Cited by 16 publications

References 24 publications

The primary treatment of prostate cancer with high-intensity focused ultrasound

The primary treatment of prostate cancer with high-intensity focused ultrasound

Partial ablation versus radical prostatectomy in intermediate-risk prostate cancer: the PART feasibility RCT

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

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