Oncologic and Functional Outcomes of Partial Gland Ablation with High Intensity Focused Ultrasound for Localized...

Area of Science:

• Urology
• Oncology
• Medical Technology

Background:

• Localized prostate cancer requires effective primary treatment options.
• Minimally invasive therapies are increasingly sought for localized prostate cancer.
• High intensity focused ultrasound (HIFU) presents a focal ablation approach.

Purpose of the Study:

• To assess the outcomes of high intensity focused ultrasound (HIFU) as a primary treatment for localized prostate cancer.
• To evaluate oncologic and functional results in intermediate and high-risk patients.
• To identify risk factors for recurrence after HIFU partial gland ablation.

Main Methods:

• Retrospective multicenter analysis of 150 patients undergoing partial gland ablation with the Sonablate® 500 system (January 2013 - September 2017).
• Inclusion criteria: biopsy-proven localized disease, limited multifocality, preference for minimally invasive outpatient therapy.
• Analysis of oncologic outcomes, functional outcomes, and recurrence risk factors.

Main Results:

• 166 procedures in 150 patients; 89% had Grade Group 2+ disease.
• Mean follow-up: 24.3 months. Mean PSA decreased by 65% (7.9 to 2.7 ng/ml).
• 42% of high-risk patients experienced recurrence; higher positive cores, medial location, and higher PSA predicted recurrence. 24.6% required salvage treatment.

Conclusions:

• Partial gland ablation with HIFU is a safe primary treatment with minimal functional impact.
• Local recurrence occurred in 42% of high-risk patients, with medial tumors showing higher failure rates.
• Whole gland treatment was avoided in 81% of patients, with rare serious complications.