Morbidity Associated with Primary High Intensity Focused Ultrasound and Redo High Intensity Focused Ultrasound for Localized Prostate Cancer

Berge, Viktor; Dickinson, Louise; McCartan, Neil; Hindley, Richard G.; Diep, Lien My; Emberton, Mark; Ahmed, Hashim U.

doi:10.1016/j.juro.2013.12.036

Cited by 29 publications

(16 citation statements)

References 11 publications

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“…When comparing our results to reported studies in the literature, the only comparable paper is that of Berge et al This analysis, from our own HEAT registry of whole‐gland HIFU cases, in men undergoing redo HIFU suggested equivalence between the rate of adverse events after first and redo treatments, and reported worse urinary function in terms of pad and leak status, both after initial HIFU treatment, and a decline in leak‐free status after redo whole‐gland HIFU, differences not observed in the present focal outcomes study.…”

Section: Discussionsupporting

confidence: 76%

“…We have previously published functional outcomes from a single session of focal HIFU and focal cryotherapy, and also the functional outcomes of second whole‐gland HIFU treatment, demonstrating minor detrimental effects . There is a paucity of data, however, on the effects of a second focal HIFU treatment on functional outcomes . We present an analysis based on data from the HEAT registry, assessing change in urinary function and erectile function (EF) measures in men who underwent a second focal HIFU procedure.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of functional outcomes after a second focal high‐intensity focused ultrasonography (HIFU) procedure in men with primary localized, non‐metastatic prostate cancer: results from the HIFU Evaluation and Assessment of Treatment (HEAT) registry

et al. 2020

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ObjectivesTo assess change in functional outcomes after a second focal high-intensity focused ultrasonography (HIFU) treatment compared with outcomes after one focal HIFU treatment. Patients and MethodsIn this multicentre study (2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016), 821 men underwent focal HIFU for localized non-metastatic prostate cancer. The patient-reported outcome measures of International Prostate Symptom Score (IPSS), pad usage and erectile function (EF) score were prospectively collected for up to 3 years. To be included in the study, completion of at least one follow-up questionnaire was required. The primary outcome was comparison of change in functional outcomes between baseline and follow-up after one focal HIFU procedure vs after a second focal HIFU procedure, using IPSS, Expanded Prostate Cancer Index Composite (EPIC) and International Index of Erectile Function (IIEF) questionnaires. ResultsOf 821 men, 654 underwent one focal HIFU procedure and 167 underwent a second focal HIFU procedure. A total of 355 (54.3%) men undergoing one focal HIFU procedure and 65 (38.9%) with a second focal HIFU procedure returned followup questionnaires, respectively. The mean age and prostatespecific antigen level were 66.4 and 65.6 years, and 7.9 and 8.4 ng/mL, respectively. After one focal HIFU treatment, the mean change in IPSS was À0.03 (P = 0.02) and in IIEF (EF score) it was À0.4 (P = 0.02) at 1-2 years, with no subsequent decline. Absolute rates of erectile dysfunction increased from 9.9% to 20.8% (P = 0.08), leak-free continence decreased from 77.9% to 72.8% (P = 0.06) and pad-free continence from 98.6% to 94.8% (P = 0.07) at 1-2 years, respectively. IPSS prior to second focal HIFU treatment compared to baseline IPSS prior to first focal HIFU treatment was lower by À1.3 (P = 0.02), but mean IPSS change was +1.4 at 1-2 years (P = 0.03) and +1.2 at 2-3 years (P = 0.003) after the second focal HIFU treatment. The mean change in EF score after the second focal HIFU treatment was À0.2 at 1-2 years (P = 0.60) and À0.5 at 2-3 years (P = 0.10), with 17.8% and 6.2% of men with new erectile dysfunction. The rate of new pad use was 1.8% at 1-2 years and 2.6% at 2-3 years. ConclusionA second focal HIFU procedure causes minor detrimental effects on urinary function and EF. These data can be used to counsel patients with non-metastatic prostate cancer prior to considering HIFU therapy.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Evaluation of functional outcomes after a second focal high‐intensity focused ultrasonography (HIFU) procedure in men with primary localized, non‐metastatic prostate cancer: results from the HIFU Evaluation and Assessment of Treatment (HEAT) registry

et al. 2020

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“…As a minimally-invasive, ambulatory therapy that requires no incisions and the unique ability to successfully repeat it in most patients, if necessary, may have some advantages over other therapies for some patients. Indeed, we have previously reported that redo-HIFU following whole-gland HIFU is associated with a small deterioration of urinary function but no deterioration in erectile function [31]. As a result, those patients, physicians, and healthcare services looking at alternative treatment strategies to radical wholegland therapy that can be delivered with low cost, conferring favourable urinary functional outcomes and acceptable medium-term cancer control, might consider whole-gland HIFU.…”

Section: Discussionmentioning

confidence: 99%

Medium-term Outcomes after Whole-gland High-intensity Focused Ultrasound for the Treatment of Nonmetastatic Prostate Cancer from a Multicentre Registry Cohort

et al. 2016

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“…Eighteen studies were identified and a total of 5695 patients treated from 43.6 to 88 years old were reported (Table 2 ). [ 3 – 20 ] The majority of patients had stage T1-T3 disease; 10 studies included cases with T3. The mean or median pre-HIFU PSA was 5 to 10 ng/mL.…”

Section: Resultsmentioning

confidence: 99%

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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Morbidity Associated with Primary High Intensity Focused Ultrasound and Redo High Intensity Focused Ultrasound for Localized Prostate Cancer

Cited by 29 publications

References 11 publications

Evaluation of functional outcomes after a second focal high‐intensity focused ultrasonography (HIFU) procedure in men with primary localized, non‐metastatic prostate cancer: results from the HIFU Evaluation and Assessment of Treatment (HEAT) registry

Evaluation of functional outcomes after a second focal high‐intensity focused ultrasonography (HIFU) procedure in men with primary localized, non‐metastatic prostate cancer: results from the HIFU Evaluation and Assessment of Treatment (HEAT) registry

Medium-term Outcomes after Whole-gland High-intensity Focused Ultrasound for the Treatment of Nonmetastatic Prostate Cancer from a Multicentre Registry Cohort

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

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