Single-center, prospective phase 2 trial of high-intensity focused ultrasound (HIFU) in patients with unilateral localized prostate cancer: good functional results but oncologically not as safe as expected

Publikation: Beitrag in FachzeitschriftForschungsartikelBeigetragenBegutachtung

Beitragende

  • Gregor Duwe - , Universitätsklinikum Mainz (Autor:in)
  • Katharina Boehm - , Klinik und Poliklinik für Urologie (Autor:in)
  • Maximilian Haack - , Universitätsklinikum Mainz (Autor:in)
  • Peter Sparwasser - , Universitätsklinikum Mainz (Autor:in)
  • Maximilian Peter Brandt - , Universitätsklinikum Mainz (Autor:in)
  • Rene Mager - , Universitätsklinikum Mainz (Autor:in)
  • Igor Tsaur - , Universitätsklinikum Mainz (Autor:in)
  • Axel Haferkamp - , Universitätsklinikum Mainz (Autor:in)
  • Thomas Höfner - , Universitätsklinikum Mainz, Department of Urology, Ordensklinikum Linz Elisabethinen, Linz, Austria (Autor:in)

Abstract

PURPOSE: Focal therapy (FT) for localized prostate cancer (PCa) is only recommended within the context of clinical trials by international guidelines. We aimed to investigate oncological follow-up and safety data of focal high-intensity focused ultrasound (HIFU) treatment.

METHODS: We conducted a single-center prospective study of 29 patients with PCa treated with (focal) HIFU between 2016 and 2021. Inclusion criteria were unilateral PCa detected by mpMRI-US-fusion prostate biopsy and maximum prostate specific antigen (PSA) of 15 ng/ml. Follow-up included mpMRI-US fusion-re-biopsies 12 and 24 months after HIFU. No re-treatment of HIFU was allowed. The primary endpoint was failure-free survival (FFS), defined as freedom from intervention due to cancer progression.

RESULTS: Median follow-up of all patients was 23 months, median age was 67 years and median preoperative PSA was 6.8 ng/ml. One year after HIFU treatment PCa was still detected in 13/ 29 patients histologically (44.8%). Two years after HIFU another 7/29 patients (24.1%) were diagnosed with PCa. Until now, PCa recurrence was detected in 11/29 patients (37.93%) which represents an FFS rate of 62%.One patient developed local metastatic disease 2 years after focal HIFU. Adverse events (AE) were low with 70% of patients remaining with sufficient erectile function for intercourse and 97% reporting full maintenance of urinary continence.

CONCLUSION: HIFU treatment in carefully selected patients is feasible. However, HIFU was oncologically not as safe as expected because of progression rates of 37.93% and risk of progression towards metastatic disease. Thus, we stopped usage of HIFU in our department.

Details

OriginalspracheEnglisch
Seiten (von - bis)1293-1299
Seitenumfang7
FachzeitschriftWorld journal of urology
Jahrgang41
Ausgabenummer5
PublikationsstatusVeröffentlicht - Mai 2023
Peer-Review-StatusJa

Externe IDs

PubMedCentral PMC10188406
Scopus 85149937548

Schlagworte

Ziele für nachhaltige Entwicklung

Schlagwörter

  • Male, Humans, Aged, Prostate-Specific Antigen, Prospective Studies, Treatment Outcome, Prostatic Neoplasms/surgery, Prostate/surgery, Ultrasound, High-Intensity Focused, Transrectal