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Focal Laser Ablation of Prostate Cancer: An Office Procedure
Published on: March 30, 2021
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A Multicentre Study of 5-year Outcomes Following Focal Therapy in Treating Clinically Significant Nonmetastatic
Stephanie Guillaumier1, Max Peters2, Manit Arya3
1Division of Surgery and Interventional Sciences, University College London, London, UK; Department of Urology, UCLH NHS Foundation Trust, London, UK.
European Urology
|July 2, 2018
Summary
Focal high-intensity focused ultrasound (HIFU) therapy offers effective medium-term control for select prostate cancer patients, with an 88% failure-free survival at 5 years and minimal side effects. This approach shows promise for treating localized prostate cancer with reduced impact.
Area of Science:
- Urology
- Oncology
- Medical Technology
Background:
- Clinically significant nonmetastatic prostate cancer (PCa) is often treated with whole-gland therapies, which can lead to urinary, sexual, and rectal side effects.
- Focal therapy presents an alternative by targeting only cancerous areas within the prostate.
Purpose of the Study:
- To evaluate the 5-year prostate cancer control rates following focal high-intensity focused ultrasound (HIFU) therapy.
- To assess the efficacy and side effect profile of focal HIFU for localized prostate cancer.
Main Methods:
- A prospective study involved 625 patients with nonmetastatic clinically significant PCa undergoing focal HIFU between 2006 and 2015.
- Disease localization utilized multiparametric MRI (mpMRI) and biopsies; treatment targeted significant disease areas.
- Follow-up included PSA monitoring, mpMRI, and biopsies to assess outcomes.
Main Results:
- At 5 years, failure-free survival (FFS) was 88%. Metastasis-free, cancer-specific, and overall survival rates were 98%, 100%, and 99%, respectively.
- Only 2% of patients experienced any pad use for urinary incontinence, indicating a low rate of side effects.
- The median follow-up was 56 months, with most patients (84%) having intermediate- or high-risk PCa.
Conclusions:
- Focal HIFU therapy is an effective medium-term treatment option for select patients with clinically significant nonmetastatic prostate cancer.
- The procedure demonstrates a low probability of side effects, particularly urinary incontinence, compared to traditional whole-gland treatments.
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