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Summary
This summary is machine-generated.

Salvage high-intensity focused ultrasound (S-HIFU) shows promising oncologic and functional outcomes for localized prostate cancer recurrence after radiotherapy. Pre-treatment PSA levels significantly predict treatment effectiveness, emphasizing early detection for salvage therapy.

Keywords:
High intensity focused ultrasoundProstate cancerRadical prostatectomyRadiotherapyRecurrence

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Area of Science:

  • Oncology
  • Urology
  • Medical Technology

Background:

  • Management of local prostate cancer (PCa) recurrence post-radiotherapy (RT) is challenging.
  • Salvage high-intensity focused ultrasound (S-HIFU) is a potential treatment option, but lacks extensive prospective data.
  • A nationwide prospective study was conducted to evaluate S-HIFU for local PCa recurrence after RT.

Purpose of the Study:

  • To assess the efficacy and safety of S-HIFU for treating local prostate cancer recurrence after primary radiotherapy.
  • To evaluate androgen deprivation therapy-free survival (ADT-FS) as the primary endpoint.
  • To analyze secondary endpoints including PCa-specific survival, overall survival, and functional outcomes.

Main Methods:

  • A prospective, nationwide study involving 531 patients across 32 French centers from 2015 to 2019.
  • Patients had biopsy-confirmed intraprostatic recurrence without regional or distant metastases.
  • Primary endpoint: ADT-FS; Secondary endpoints: PCa-specific survival, overall survival, functional outcomes, and quality of life.

Main Results:

  • The 30-month ADT-FS was 71% in the overall cohort.
  • Favorable ADT-FS rates (84%) were observed in patients with pre-S-HIFU PSA ≤ 4.5 ng/ml and Gleason score 6-7.
  • High-grade complications occurred in 3.6% of patients, with a rise in severe incontinence from 7% to 12%; quality of life remained stable.

Conclusions:

  • This large prospective trial indicates favorable oncologic and functional outcomes for S-HIFU in treating local PCa recurrence post-RT.
  • Pre-S-HIFU PSA levels are crucial for predicting treatment efficacy, highlighting the need for early recurrence detection.
  • Further high-level evidence trials are needed to compare S-HIFU with other salvage local treatment options.