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Long-term outcomes of whole gland high-intensity focused ultrasound for localized prostate cancer

  • Urology - Original Paper
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Abstract

Objectives

To report the 10-year oncologic and functional outcomes of whole-gland HIFU as first-line treatment for localized prostate cancer (PCa).

Patients and Methods

Patients were retrospectively included between January 2005 and July 2018 from a prospectively maintained database at a single academic institution. No patient underwent androgen deprivation therapy prior to HIFU. Primary endpoint was biochemical recurrence-free survival (BRFS). Secondary oncological endpoints included salvage treatment-free survival (STFS), cancer-specific survival (CSS) and overall survival (OS).

Results

A total of 97 patients met our inclusion criteria and were included in the final analysis. According to D’Amico classification, the numbers of patients with low-, intermediate-, and high-risk disease were 38 (39.2%), 52 (53.6%), and 7 (7.2%). A total of 21 (21.6%) patients received salvage treatment at a mean of 4.1 years (± 2.8) after HIFU. The 10-year OS, CSS and BRFS rates were 91.8%, 100% and 40.3% in the overall cohort, respectively. In multivariate analysis, predictive factors for biochemical recurrence were intermediate-risk group (RR = 2.065; 95% CI 1.008–4.230; p = 0.047) and PSA nadir > 0.5 ng/mL (RR = 4.963; 95% CI 2.251–10.947; p < 0.001). Symptoms related to bladder outlet obstruction were the most frequently recorded adverse events. In multivariate analysis, positive biopsy on the prostatic apex was predictor of obstructive complications (RR = 3.2, 95% CI 1.092–9.476, p = 0.034). Only four patients developed severe urinary incontinence (> 1 pad/day).

Conclusions

HIFU showed low PCa-specific mortality, but biochemical recurrence rates were highly variable among patients. Future studies are needed to improve patient selection.

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Acknowledgement

We thank EDAP TMS for the prospective maintenance of the database in collaboration with our institution.

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Authors and Affiliations

  1. Department of Urology, North Hospital, Aix-Marseille University, APHM, Marseille, France

    Kevin Lo Verde, Harry Toledano, Jennifer Campagna, Dominique Rossi, Cyrille Bastide & Michael Baboudjian

  2. Department of Urology, Martigues Hospital, Martigues, France

    Harry Toledano

  3. Department of Urology, La Conception Hospital, Aix-Marseille University, APHM, Marseille, France

    Michael Baboudjian

  4. Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain

    Michael Baboudjian

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  1. Kevin Lo Verde
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  2. Harry Toledano
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  3. Jennifer Campagna
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  4. Dominique Rossi
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  5. Cyrille Bastide
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Correspondence to Michael Baboudjian.

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Lo Verde, K., Toledano, H., Campagna, J. et al. Long-term outcomes of whole gland high-intensity focused ultrasound for localized prostate cancer. Int Urol Nephrol 54, 1233–1238 (2022). https://doi.org/10.1007/s11255-022-03156-x

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  • DOI: https://doi.org/10.1007/s11255-022-03156-x

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