Visually Directed Transrectal High Intensity Focused Ultrasound for the Treatment of Prostate Cancer: A Preliminary Report on the Italian Experience

Mearini, Luigi; D’Urso, Leonardo; Collura, Devis; Zucchi, Alessandro; Costantini, Elisabetta; Formiconi, Andrea; Bini, Vittorio; Muto, Giovanni; Porena, Massimo

doi:10.1016/j.juro.2008.09.024

Cited by 49 publications

(46 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, comparing these outcomes with previous studies is not feasible due to the heterogeneity in patient selection and the definition of biochemical failure. Some authors have defined biochemical failure using the ASTRO definition (three consecutive PSA rises) [3,10,13], whereas more recent studies, including our study, have used the Phoenix criteria [1,[8][9]. Although the definitions of BFSR and DFSR in our study were similar to those in Blana's study [8], they excluded higher risk patients (cT2c, Gleason score 17, preoperative PSA 120 ng/ml), so that their results cannot be compared directly to our own.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Clinically Significant Urethral Stricture and/or Subclinical Urethral Stricture after High-Intensity Focused Ultrasound Correlates with Disease-Free Survival in Patients with Localized Prostate Cancer

et al. 2011

View full text Add to dashboard Cite

Purpose: To assess the association between the development of a urethral stricture (US) and disease-free survival for patients with localized prostate cancer treated with high-intensity focused ultrasound (HIFU). Patients and Methods: Patients with clinical stage T1-T2N0M0 prostate cancer were eligible for treatment with HIFU. Treatment failure was defined according to the Phoenix criteria, and the disease-free survival rate (DFSR) was evaluated using this definition. Patients were divided into two subgroups according to whether or not they developed a US or a subclinical urethral stricture (SCUS) during follow-up. SCUS was defined as clinically insignificant bladder outlet obstruction requiring transient catheterization. Results: A total of 144 patients were included in the present study. The median follow-up time was 47 months (range 2–70). Grade 1–4 US occurred during follow-up in 28 (19.5%) patients and SCUS was found in 30 (20.8%). The 5-year DFSR by Kaplan-Meier estimation was 61.2% for the entire cohort, 78.2% for patients who developed a US/SCUS and 47.8% for those without US or SCUS (p < 0.001). On Cox regression analysis, development of US/SCUS proved to be an independent predictor of DFSR. Conclusions: Development of US/SCUS was identified as a predictor of favorable HIFU treatment outcome.

show abstract

Section: Discussionmentioning

confidence: 90%

“…We found that subclinical strictures were difficult to detect and would likely not have been registered without following CTC-NCI version 3.0 criteria. Most literature reports likely considered only grade 3 or 4 strictures [1,[8][9][10]. We considered 20.8% of patients to have SCUS.…”

Section: Discussionmentioning

confidence: 99%

Clinically Significant Urethral Stricture and/or Subclinical Urethral Stricture after High-Intensity Focused Ultrasound Correlates with Disease-Free Survival in Patients with Localized Prostate Cancer

et al. 2011

View full text Add to dashboard Cite

show abstract

“…Moreover, careful selection when treating patients with primary HIFU is essential, since there is a large range in BF rate (15-50%), which varies depending on risk group at diagnosis [4,13]. Little is known about the best treatment option at relapse, mainly because the current evidence is mostly based on small series, usually with a short median follow-up, making it very difficult to draw any definitive conclusion.…”

Section: Discussionmentioning

confidence: 99%

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

et al. 2013

Self Cite

View full text Add to dashboard Cite

Introduction: The main objective was to evaluate feasibility, toxicity and biochemical control rates of salvage external beam radiotherapy (EBRT) in recurrent localized prostate cancer after high-intensity focused ultrasound (HIFU) as primary therapy. Patients and Methods: A total of 24 patients who underwent salvage EBRT after 1 or 2 HIFU sessions and with a minimum post-treatment follow-up of 24 months were retrospectively evaluated. Primary endpoints were toxicity and biochemical disease-free survival (bDFS, defined according to the ASTRO Phoenix definition). Results: Median follow-up was 40.3 months. Gastrointestinal toxicity was low. Acute genitourinary (GU) toxicity grade ≤II rate was 45.8%, with only few patients presenting grade III (8.3%) and grade IV (4.2%) toxicity. Late grade ≥III GU toxicity was registered in 16.7% of patients. The 3-year bDFS rate was 77.8%. Patients achieving a nadir prostate-specific antigen (nPSA) of ≤0.35 ng/ml after EBRT had significantly higher bDFS (3-year bDFS: 87.7 vs. 50%, respectively; p = 0.001). Achieving nPSA ≤0.35 ng/ml was the only factor independently associated to long-term bDFS both on univariate (p = 0.01) and multivariate analysis (HR 7.06, p = 0.039). Conclusions: Salvage EBRT after HIFU failure is feasible and allows to obtain satisfactory biochemical control rates, especially in patients attaining a nPSA ≤0.35 ng/ml after EBRT.

show abstract

“…These results concur with other recent reports. 15,16 We used the Phoenix definition plus histological results as a basis for judgment of disease-free survival, since we were not satisfied with other definitions currently used to measure the efficacy of HIFU treatment. Recently, specific criteria for assessment of HIFU have been proposed (the Stuttgart criteria), 17 and we intend to compare the results based on the Phoenix-ASTRO and Stuttgart criteria in a future study.…”

Section: Discussionmentioning

confidence: 99%

Transrectal high‐intensity focused ultrasound for treatment of localized prostate cancer

Inoue¹,

Goto²,

Hayashi³

et al. 2011

Int J of Urology

View full text Add to dashboard Cite

Objectives:To assess the long-term outcomes of transrectal high-intensity focused ultrasound (HIFU) for patients with localized prostate cancer. Methods: From May 2003 to present, 137 consecutive patients with T1-2 prostate cancer were treated using the Sonablate 500 and then followed for more than 12 months after their last HIFU treatment. A prostate biopsy was routinely carried out at 6 months and serum prostate-specific antigen (PSA) was measured every 3 months after HIFU. Oncological outcomes as well as treatment-related complications were assessed. Disease-free survival (DFS) was judged using the Phoenix definition (PSA nadir + 2 ng/mL), negative histological findings and no local or distant metastasis. Results:The median follow up after HIFU was 36 months (range 12-84 months). No patients received adjuvant therapy during this period. The PSA nadir occurred at 2 months after HIFU and the median level was 0.07 ng/mL (0.01-2.01 ng/mL). Of the 133 patients who underwent prostate biopsy or transurethral resection of the prostate at 6 months or later after HIFU, six were positive for cancer cells (4.5%). There were no major postoperative complications, but urge incontinence (16 cases) and dysuria (33 cases) occurred after removal of the urethral catheter. The 5-year DFS rate was 78% based on these criteria, and 91%, 81% and 62% in the low-, intermediate-and high-risk group, respectively. Conclusions: HIFU represents an effective, repeatable and minimally invasive treatment. It is particularly effective for low-and intermediate-risk patients, and it should be considered as an option for localized prostate cancer.

show abstract

Visually Directed Transrectal High Intensity Focused Ultrasound for the Treatment of Prostate Cancer: A Preliminary Report on the Italian Experience

Cited by 49 publications

References 19 publications

Clinically Significant Urethral Stricture and/or Subclinical Urethral Stricture after High-Intensity Focused Ultrasound Correlates with Disease-Free Survival in Patients with Localized Prostate Cancer

Clinically Significant Urethral Stricture and/or Subclinical Urethral Stricture after High-Intensity Focused Ultrasound Correlates with Disease-Free Survival in Patients with Localized Prostate Cancer

Salvage External Beam Radiotherapy for Recurrent Prostate Adenocarcinoma after High-Intensity Focused Ultrasound as Primary Treatment

Transrectal high‐intensity focused ultrasound for treatment of localized prostate cancer

Contact Info

Product

Resources

About