High‐intensity focused ultrasound in prostate cancer; a systematic literature review of the French Association of Urology

Abstract

antigen (PSA) level of ≤ 28 ng/mL and a prostate volume of ≤ 40 mL. Negative biopsy rates with the Ablatherm TM device (EDAP TMS S.A., Vaulx-en-Velin, France) were 64-93%, and a PSA nadir of ≤ 0.5 ng/mL was achieved in 55-84% of patients. The 5-year actuarial disease-free survival rates were 60-70%. The most common complications were stress urinary incontinence, urinary tract infection, urethral/bladder neck stenosis or strictures, and erectile dysfunction. For the Ablatherm device, the rate of complications has been significantly reduced over the years, due to technical improvements in the device and the use of transurethral resection of the prostate before HIFU. In conclusion, HIFU as primary therapy for prostate cancer is indicated in older patients ( ≥ 70 years) with T1-T2 N0M0 disease, a Gleason score of < 7, a PSA level of < 15 ng/mL and a prostate volume of < 40 mL. In these patients HIFU achieves short-term cancer control, as shown by a high percentage of negative biopsies and significantly reduced PSA levels. The median-term survival data also seem promising, but long-term follow-up studies are needed to further evaluate cancerspecific and overall survival rates before the indications for primary therapy can be expanded.

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates

“…18,19 The efficacy of FT has not been well-documented because of immature collective experience and relatively small patient cohorts. Short-term control rates of 55% to 84% have been reported in high intensity focused ultrasound case series, 20 while success rates of 88% to 94% have been noticed in cryoablation studies, based on postoperative PSA stability after about 2 years of follow-up. 2,21 The ultimate success and applicability of FT relies mainly on preoperative patient selection and optimal tumour characterization to maximize cancer control and minimize morbidity.…”

Histotripsy Homogenization of the Prostate: Thresholds for Cavitation Damage of Periprostatic Structures

“…[6][7][8][9] Histotripsy uses cavitation, which is a threshold phenomenon. When acoustic pressure perturbations within the focal volume of the transducer are large enough (ie, negative pressure swings sufficiently low), cavitation will occur.…”

Transrectal high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer: review of technical incidents and morbidity after 5 years of use

“…10 The de novo postoperative ED rate in our study was 77.1% when compared with rates of 20 and 77% in recent studies. 23,24 We prescribed postoperative ED therapy to a higher proportion of patients (n ¼ 8, 29.6%) than did another study (20%). 25 However, our study was not a review of a prospectively maintained database, the population size was relatively small and we did not use a validated potency questionnaire.…”