High-intensity focused ultrasound for the treatment of prostate cancer: A prospective trial with long-term follow-up. (August 2014)

• Record Type: Journal Article
• Authors: Mearini, Luigi; D'Urso, Leonardo; Collura, Devis; Nunzi, Elisabetta; Muto, Giovanni; Porena, Massimo
• Is Part Of: Scandinavian journal of urology. Volume 49:Number 4(2015)
• Page Start: 267
• Page End: 274
• Publication Date: 2014-08
• Subjects: Urology -- Periodicals; 616.6
• DOI: 10.3109/21681805.2014.988174
• Languages: English
• ISSNs: 2168-1805

Abstract

<abstract> <title>Abstract</title> <p> <italic>Objective.</italic> High-intensity focused ultrasound (HIFU) is a minimally invasive treatment for prostate cancer. Data from the literature show promising oncological outcomes with a favourable side-effect profile. The aim of this study was to re-evaluate and bring up to date the follow-up of a previously published, prospective trial on HIFU as the primary treatment for prostate cancer. <italic>Materials and methods.</italic> Between 2004 and 2007, 163 consecutive men with T1–T3N0M0 prostate cancer underwent HIFU with the Sonablate® 500. Follow-up included prostate-specific antigen (PSA) tests every 3 months after treatment and a random prostate biopsy at 6 months. Failure was defined according to positive findings at the 6 month biopsy and biochemical failure was defined according to the Phoenix criteria. Biochemical-free survival, metastasis-free survival and cancer-specific survival were calculated by Kaplan–Meier curves. <italic>Results.</italic> Median follow-up was 72.0 months. Of the 160 evaluable patients, 104 (65%) were biochemically disease free; in low- to intermediate-risk disease, on Kaplan–Meier analysis the 8 year biochemical-non-evidence of disease (bNED), metastasis-free survival and cancer-specific survival rates were 69.6%, 81.3%, 100% and 40.5%, 60.6%, 100%, respectively. A PSA nadir below 0.40 ng/ml and risk stratification have an independent predictive value for bNED and metastasis-free survival. <italic>Conclusions.</italic> A long-term favourable outcome of HIFU is associated with careful patient selection, with low- to intermediate-risk disease being the ideal case. A low postoperative PSA nadir is a predictor of long-term bNED.</p> </abstract>