Focal Therapy with High-intensity-focused Ultrasound in the Treatment of Localized Prostate Cancer

Muto, Satoru; Yoshii, Takashi; Saito, Keisuke; Kamiyama, Yutaka; Ide, Hisamitsu; Horie, Shigeo

doi:10.1093/jjco/hym173

Cited by 192 publications

(97 citation statements)

References 42 publications

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“…No significant differences were observed in the 2 year biochemical disease free survival for patients in the low and intermediate risk groups. Complications tended to be lower in the focal therapy group (20).…”

Section: Commentsmentioning

confidence: 82%

Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up

et al. 2011

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Purpose: To evaluate the long-term efficacy of prostate cancer control and complication rates, in the elderly, after focal therapy with high-intensity focused ultrasound (HIFU). Materials and Methods: Between June 1997 and March 2000, patients with localized prostate cancer were included into a focal therapy protocol. Inclusion criteria were: PSA ≤ 10 ng/mL, ≤ 3 positive biopsies with only 1 lobe involved, clinical stage ≤ T2a, Gleason score ≤ 7 (3+4), negative CT scan and bone scan. Hemi-ablation of the prostate was performed with the Ablatherm (R) device. Survival, complication rates and urinary continence were evaluated. Control biopsies were performed at 1 year. Treatment failure was defined as a positive biopsy or need for salvage therapy. Results: Twelve patients with a mean age 70 years were included. Median follow-up was 10 years. Control prostate biopsies were negative in 11/12 (91%) patients. Overall survival was 83% (10/12) and cancer specific survival was 100% at 10 years. Two patients died from other causes. Recurrence free survival was 90% (95% CI; 0.71-1) at 5 years, and 38% (95% CI; 0.04-0.73) at 10 years. Five patients had salvage therapy with repeat HIFU (n = 1) or hormonal therapy (n = 4) and all salvage patients were alive at 10 years. No patients developed lymph node or bone metastasis. No patients suffered from urinary incontinence. International Prostate Symptom Score was stable at 1 year. Complications included two urinary tract infections and one episode of acute urinary retention. Conclusions: Hemi-prostate ablation with HIFU can be safely performed in selected elderly patients with adequate longterm cancer control and low complication rates. Results from larger prospective studies using improved imaging techniques and extensive biopsy protocols are awaited.

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Section: Commentsmentioning

confidence: 82%

Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up

et al. 2011

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“…46 A comparison of whole to hemi-gland therapy revealed no significant differences in biochemical disease free survival, but no differences in quality of life measures were noted either. 51 Conversely, Beerlage et al report that patients with selective lesion-targeted HIFU have reduced local control based on biopsy findings and increased PSA nadir. 52 There is one report in the literature regarding focal PDT.…”

Section: Dovepressmentioning

confidence: 99%

The new era of minimally invasive interventions for prostate cancer: robot-assisted laparoscopic radical prostatectomy and focal therapy

Schatloff¹,

Louis²,

Lindner³

2011

OAS

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Prostate cancer remains a common but highly treatable disease. Innovations in prostate cancer treatment have allowed a transition toward minimally invasive approaches in an attempt to avoid treatment-related morbidities. In the middle of the treatment spectrum between radical open surgeries and active surveillance lies robot-assisted laparoscopic radical prostatectomy (RALP) and focal therapy (FT). This review sets out the most current information on RALP and FT (including laser ablation, cryotherapy, high-intensity focused ultrasound, photodynamic therapy, and irreversible electroporation).

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“…[9][10][11][12][13] In previous studies, complications reported included the rate of bladder outlet obstruction, urinary incontinence and erectile dysfunction, and their incidence was 0-5.0%, 0-10% and 5.0-6.0%, respectively.…”

Section: Introductionmentioning

confidence: 99%

Morphological analysis of the effects of intraoperative transrectal compression of the prostate during high‐intensity focused ultrasound for localized prostate cancer

et al. 2015

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Abbreviations & Acronyms 3-D = three-dimensional BDFS = biochemical diseasefree survival rate DVC = dorsal vein complex HIFU = high-intensity focused ultrasound MRI = magnetic resonance imaging PSA = prostate-specific antigen PZ = peripheral zone TRUS = transrectal ultrasound TZ = transition zone Objectives: To evaluate the effects of transrectal compression of the prostate for intraoperative prostatic swelling and intraprostatic point shift during high-intensity focused ultrasound treatment of localized prostate cancer. Methods: Patients treated with whole-gland high-intensity focused ultrasound as primary monotherapy for localized prostate cancer were enrolled in the study. Using the standard and compression method, the volumes of degassed water in the balloon covering the high-intensity focused ultrasound probe were 50 mL and 80-160 mL, respectively. To identify prostatic swelling and shift during high-intensity focused ultrasound and the volume occupied by the non-enhanced area, three-dimensional prostate models were reconstructed using ultrasound and contrast-enhanced magnetic resonance imaging. Results: In comparison with the standard (n = 40) and compression (n = 48) methods, intraoperative increase in the prostate volume (21% vs 5.3%; P = 0.044), intraprostatic point shift (4 mm vs 2 mm, P = 0.040 in the transition zone; 3 mm vs 0 mm; P = 0.001 in the peripheral zone) and the volume occupied by the non-enhanced area (89% vs 96%; P = 0.001) were significantly suppressed. The biochemical disease-free survival rate in patients treated using the compression method was significantly improved relative to the standard method (92.6% vs 76.5%; P = 0.038). Regarding complications, there was no significant difference in the rate of urethral stricture (P = 0.9), urinary tract infection (P = 0.9), incontinence (P = 0.3), erectile dysfunction (P = 0.9) or recto-urethral fistula between the patients treated using the standard and compression methods. Conclusions: Intraoperative transrectal compression suppresses intraoperative increase in the prostate volume and intraprostatic point shift during high-intensity focused ultrasound, having the potential to achieve precise whole-gland and lesion-targeted focal therapy.

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Focal Therapy with High-intensity-focused Ultrasound in the Treatment of Localized Prostate Cancer

Cited by 192 publications

References 42 publications

Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up

Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up

The new era of minimally invasive interventions for prostate cancer: robot-assisted laparoscopic radical prostatectomy and focal therapy

Morphological analysis of the effects of intraoperative transrectal compression of the prostate during high‐intensity focused ultrasound for localized prostate cancer

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