Survival Outcomes and Recurrence Patterns Following Focal High-intensity Focused Ultrasound Treatment for Localized
Bruno Nahar1, Tarek Ajami2, Adam Williams1
1Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, FL, USA.
European Urology Focus
|November 29, 2024
Summary
High-intensity focused ultrasound (HIFU) shows promise for localized prostate cancer (PC) in carefully selected patients. However, higher-risk PC patients experienced more treatment failures and recurrence after HIFU.
Area of Science:
- Oncology
- Urology
- Medical Physics
Background:
- Focal therapy, including high-intensity focused ultrasound (HIFU), is emerging as a treatment option for localized prostate cancer (PC).
- Evaluating oncological outcomes and recurrence patterns is crucial for optimizing HIFU treatment strategies.
- Patient selection is key to maximizing the effectiveness of HIFU for PC.
Purpose of the Study:
- To assess oncological outcomes, recurrence patterns, and survival rates following focal HIFU treatment for localized PC.
- To share lessons learned from clinical experience with HIFU.
- To propose strategies for improving patient selection for HIFU therapy.
Main Methods:
- A cohort of 113 patients with PC underwent focal HIFU between 2016 and 2023.
- Follow-up involved regular prostate-specific antigen (PSA) monitoring, magnetic resonance imaging, and biopsies.
- Recurrence was analyzed based on location and clinical significance, with survival outcomes assessed using Kaplan-Meier curves.
Main Results:
- Local recurrence occurred in 37% of patients, with 17% experiencing clinically significant recurrence.
- Three-year recurrence-free survival was significantly lower for high-risk and unfavorable intermediate-risk PC patients (40% and 53%) compared to favorable intermediate-risk PC (85%).
- The retreatment-free survival rate was 71% at 3 years, with 17% of patients undergoing salvage treatment.
Conclusions:
- HIFU is a viable treatment for localized PC in well-selected patients.
- Patients with high-risk or unfavorable intermediate-risk PC face a higher likelihood of treatment failure with HIFU.
- Further refinement in patient selection is necessary to enhance HIFU efficacy for prostate cancer.
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