Pd17-03 five-Year Outcomes From a Prospective Phase I Study of Mri-Guided Transurethral Ultrasound Ablation in Men With Localized Prostate Cancer

Nair, Shiva M.; Hatiboglu, Gencay; Relle, James; Hafron, Jason; Reothke, Matthias; Mueller-Wolf, Maya; Bonekamp, David; Kassam, Zahra; Staruch, Robert; Burtnyk, Mathieu; Pahernik, Sasha; Chin, Joseph L.

doi:10.1097/ju.0000000000000860.03

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“…The PSA decline from baseline to 1 to 2 years for all included studies with the PSA supplied at follow-up and including all ablation fractions was from 54% to 97% ( Table 2 ). At a 5-year follow-up, the PSA decline was 89%, 13 while the early decline in PSA at 3 weeks after treatment was 34%. 14 …”

Section: Evidence Synthesis and Resultsmentioning

confidence: 89%

“…Feasibility was also assessed in a prospective Phase I study ( n = 30) 11 with up to 5-year follow-up. 12 , 13 However, a nononcologic treatment plan was applied and the intent of the study was to assess the feasibility and not to achieve definitive treatment. Therefore, the rates of salvage treatment, clinically significant disease, MRI recurrence, and BCR from the Phase I study were not included in the present synthesis.…”

Section: Evidence Synthesis and Resultsmentioning

confidence: 99%

“… 12 For the 16 men with a complete 5-year follow-up, 9/16 and 7/16 had erections sufficient for penetration at baseline and follow-up. 13 …”

Section: Evidence Synthesis and Resultsmentioning

confidence: 99%

“… 23 , 24 Pad-free continence was preserved in 179/189 men (95%), durable to 5 years ( Table 2 ). 13 Favorable IPSSs were maintained in men with good baseline function, while 83% to 89% of men with LUTS in addition to PCa met the criteria for symptom improvement ( Table 3 ). 10 , 17 …”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer: A Systematic Review

Dora

Clarke

Frey

et al. 2022

Journal of Endourology

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Purpose: MRI-guided transurethral ultrasound ablation (TULSA) uses real-time MR thermometry feedback to target prostate disease. We systematically review the literature to synthesize efficacy, functional, and safety outcomes and assess the influence of planned ablation fraction on outcome. Materials and Methods: PubMed, Embase, and the Cochrane Library were searched from inception to June 2021 following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies reporting at least one efficacy, functional, or safety outcome after a single TULSA treatment were included. The relationship of freedom from salvage treatment and potency preservation with planned ablation volume was modeled. Results: Two hundred twenty-four patients were treated in 10 studies with up to a 5-year follow-up, mainly for primary localized prostate cancer (PCa) plus smaller cohorts with recurrent PCa, and locally advanced PCa (LAPC). The prostate-specific antigen decline from baseline up to 2 years, including focal to whole-gland ablation plans, was 54% to 97%. The rate of salvage treatment after one TULSA treatment for primary PCa was 7% to 17%. Continence and potency preservation were from 92% to 100% and from 75% to 98%. Urinary symptoms were stable in men with good voiding function at baseline, and 85% of men with concurrent PCa and lower urinary tract symptoms met the criteria for improvement. Symptom relief in a small cohort of men with LAPC was observed. Grade III adverse events were incurred by 13/224 men (6%), with no rectal injury/fistula or Grade IV complication. The planned ablation fraction was linearly related to salvage-free survival. The relationship between potency preservation and planned ablation fraction followed a sigmoid curve. Conclusions: As an alternative to conventional treatments, TULSA is safe and effective for prostate tissue ablation in men with primary PCa. There is also evidence that TULSA delivers effective relief of urinary symptoms while treating PCa in a single, low-morbidity procedure. The likelihood of freedom from additional treatment or potency preservation is associated with the planned ablation fraction.

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Section: Evidence Synthesis and Resultsmentioning

confidence: 89%

Section: Evidence Synthesis and Resultsmentioning

confidence: 99%

“… 12 For the 16 men with a complete 5-year follow-up, 9/16 and 7/16 had erections sufficient for penetration at baseline and follow-up. 13 …”

Section: Evidence Synthesis and Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer: A Systematic Review

Dora

Clarke

Frey

et al. 2022

Journal of Endourology

View full text Add to dashboard Cite

show abstract

Pd17-03 five-Year Outcomes From a Prospective Phase I Study of Mri-Guided Transurethral Ultrasound Ablation in Men With Localized Prostate Cancer

Abstract: INTRODUCTION AND OBJECTIVE: MRI-guided transurethral ultrasound ablation (TULSA) is a minimally-invasive procedure for customized ablation of benign and malignant prostate tissue. We

Cited by 1 publication

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Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer: A Systematic Review

Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer: A Systematic Review

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