The real-time intraoperative guidance of the new HIFU Focal-One® platform allows to minimize the perioperative adverse events in salvage setting

Checcucci, Enrico; Luca, Stefano De; Piramide, Federico; Garrou, D.; Mosca, Alessandra; Galla, A.; Belli, Gaetano; Russo, Filippo; Rescigno, Pasquale; Poti, Carlo; Verri, Paolo; Volpi, G.; Manfredi, Matteo; Fiori, Cristian; Porpiglia, Francesco

doi:10.1007/s40477-021-00594-8

Cited by 6 publications

(4 citation statements)

References 21 publications

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“…Data indicate that combination mpMRI may be the most effective in detecting BCR among mpMRI modalities, and further investigation is warranted. Prospective data also suggest a potential role for mpMRI to guide salvage high-intensity focused ultrasound (sHIFU) in patients with BCR post-EBRT, evaluate local recurrence prior to and following the sHIFU, and inform subsequent treatment decisions [ 76 ].…”

Section: Resultsmentioning

confidence: 99%

Application of next-generation imaging in biochemically recurrent prostate cancer

Moul,

Shore,

Pienta

et al. 2023

Prostate Cancer Prostatic Dis

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Background Biochemical recurrence (BCR) following primary interventional treatment occurs in approximately one-third of patients with prostate cancer (PCa). Next-generation imaging (NGI) can identify local and metastatic recurrence with greater sensitivity than conventional imaging, potentially allowing for more effective interventions. This narrative review examines the current clinical evidence on the utility of NGI for patients with BCR. Methods A search of PubMed was conducted to identify relevant publications on NGI applied to BCR. Given other relevant recent reviews on the topic, this review focused on papers published between January 2018 to May 2023. Results NGI technologies, including positron emission tomography (PET) radiotracers and multiparametric magnetic resonance imaging, have demonstrated increased sensitivity and selectivity for diagnosing BCR at prostate-specific antigen (PSA) concentrations <2.0 ng/ml. Detection rates range between 46% and 50%, with decreasing PSA levels for choline (1–3 ng/ml), fluciclovine (0.5–1 ng/ml), and prostate-specific membrane antigen (0.2–0.49 ng/ml) PET radiotracers. Expert working groups and European and US medical societies recommend NGI for patients with BCR. Conclusions Available data support the improved detection performance and selectivity of NGI modalities versus conventional imaging techniques; however, limited clinical evidence exists demonstrating the application of NGI to treatment decision-making and its impact on patient outcomes. The emergence of NGI and displacement of conventional imaging may require a reexamination of the current definitions of BCR, altering our understanding of early recurrence. Redefining the BCR disease state by formalizing the role of NGI in patient management decisions will facilitate greater alignment across research efforts and better reflect the published literature.

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Section: Resultsmentioning

confidence: 99%

Application of next-generation imaging in biochemically recurrent prostate cancer

Moul,

Shore,

Pienta

et al. 2023

Prostate Cancer Prostatic Dis

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“…Recently, Checcucci et al . 33 first introduced a new focal one high-intensity focused ultrasound platform. They prospectively included 20 patients with radiorecurrence and concluded that this therapy allows continuous monitoring and tailoring of the treatment and minimizes adverse events.…”

Section: Discussionmentioning

confidence: 99%

The comparison of survival between active surveillance or watchful waiting and focal laser ablation in patients with low-risk prostate cancer

Zhang

Qiu

et al. 2022

Asian Journal of Andrology

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Prostate cancer (PCa) is the second-most common cancer among men. Both active surveillance or watchful waiting (AS/WW) and focal laser ablation (FLA) can avoid the complications caused by radical treatment. How to make the choice between these options in clinical practice needs further study. Therefore, this study aims to compare and analyze their effects based on overall survival (OS) and cancer-specific survival (CSS) to obtain better long-term benefits. We included patients with low-risk PCa from the Surveillance Epidemiology and End Results database of 2010–2016. Multivariate Cox proportional hazard analyses were conducted for OS and CSS in the two groups. To eliminate bias, this study applied a series of sensitivity analyses. Moreover, Kaplan–Meier curves were plotted to obtain survival status. A total of 18 841 patients with low-risk PCa were included, with a median of 36-month follow-up. According to the multivariate Cox proportional hazard regression, the FLA group presented inferior survival benefits in OS than the AS/WW group (hazard ratio [HR]: 2.13, 95% confidence interval [CI]: 1.37–3.33, P < 0.05). After adjusting for confounders, the result persisted (HR: 1.69, 95% CI: 1.02–2.81, P < 0.05). According to the results of the sensitivity analysis, the inverse probability of the treatment weighing model indicated the same result in OS. In conclusion, AS/WW and FLA have the advantage of fewer side effects and the benefit of avoiding overtreatment compared with standard treatment. Our study suggested that AS/WW provides more survival benefits for patients with low-risk PCa. More relevant researches and data will be needed for further clarity.

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“…Still, the procedure is extremely technically demanding, and intraoperative and postoperative complications should not be understated. Furthermore, compared to other salvage modalities such as HIFU or cryoablation, salvage RP may increase the risk of incontinence and impotence [62].…”

Section: Comparison To Alternate Salvage Therapymentioning

confidence: 99%

The Role of Salvage Radical Prostatectomy in Patients with Radiation-Resistant Prostate Cancer

Drobner

Kaldany

Shah

et al. 2023

Cancers

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There are multiple treatment strategies for patients with localized prostate adenocarcinoma. In intermediate- and high-risk patients, external beam radiation therapy demonstrates effective long-term cancer control rates comparable to radical prostatectomy. In patients who opt for initial radiotherapy but have a local recurrence of their cancer, there is no unanimity on the optimal salvage approach. The lack of randomized trials comparing surgery to other local salvage therapy or observation makes it difficult to ascertain the ideal management. A narrative review of existing prospective and retrospective data related to salvage radical prostatectomy after radiation therapy was undertaken. Based on retrospective and prospective data, post-radiation salvage radical prostatectomy confers oncologic benefits, with overall survival ranging from 84 to 95% at 5 years and from 52 to 77% at 10 years. Functional morbidity after salvage prostatectomy remains high, with rates of post-surgical incontinence and erectile dysfunction ranging from 21 to 93% and 28 to 100%, respectively. Factors associated with poor outcomes after post-radiation salvage prostatectomy include preoperative PSA, the Gleason score, post-prostatectomy staging, and nodal involvement. Salvage radical prostatectomy represents an effective treatment option for patients with biochemical recurrence after radiotherapy, although careful patient selection is important to optimize oncologic and functional outcomes.

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The real-time intraoperative guidance of the new HIFU Focal-One® platform allows to minimize the perioperative adverse events in salvage setting

Cited by 6 publications

References 21 publications

Application of next-generation imaging in biochemically recurrent prostate cancer

Application of next-generation imaging in biochemically recurrent prostate cancer

The comparison of survival between active surveillance or watchful waiting and focal laser ablation in patients with low-risk prostate cancer

The Role of Salvage Radical Prostatectomy in Patients with Radiation-Resistant Prostate Cancer

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