| Item type: | Article | ||||
|---|---|---|---|---|---|
| Journal or Publication Title: | European Urology Focus | ||||
| Publisher: | Elsevier | ||||
| Place of Publication: | AMSTERDAM | ||||
| Volume: | 8 | ||||
| Number of Issue or Book Chapter: | 1 | ||||
| Page Range: | pp. 134-140 | ||||
| Date: | 2022 | ||||
| Institutions: | Medicine > Lehrstuhl für Urologie Medicine > Zentren des Universitätsklinikums Regensburg > Zentrum für Klinische Studien | ||||
| Identification Number: |
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| Keywords: | RADICAL PROSTATECTOMY; THERAPY; High-intensity focused; ultrasound; Oncological outcome; Long term; Prostate cancer | ||||
| Dewey Decimal Classification: | 600 Technology > 610 Medical sciences Medicine | ||||
| Status: | Published | ||||
| Refereed: | Yes, this version has been refereed | ||||
| Created at the University of Regensburg: | Yes | ||||
| Item ID: | 57078 |
Web of ScienceAbstract
Background: Owing to the morbidity of established radical treatment options for prostate cancer, alternative whole-gland and focal treatment strategies have emerged. High-intensity focused ultrasound (HIFU) is one of the most studied sources for tissue ablation and has been used since the 1990s. Objective: To provide 21-yr oncological long-term follow-up data of an unselected series of patients ...
Abstract
Background: Owing to the morbidity of established radical treatment options for prostate cancer, alternative whole-gland and focal treatment strategies have emerged. High-intensity focused ultrasound (HIFU) is one of the most studied sources for tissue ablation and has been used since the 1990s. Objective: To provide 21-yr oncological long-term follow-up data of an unselected series of patients who underwent whole-gland HIFU for nonmetastatic prostYate cancer. Design, setting, and participants: A total of 674 patients were treated between November 1997 and November 2012 in one university center. Outcome measurements and statistical analysis: The oncological outcome was assessed by biopsy failure-free survival (BFFS), salvage treatment-free survival (STFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS). Multivariable Cox proportional hazard regression analyses were performed to estimate the prognostic relevance of clinical variables. Results and limitations: In total, 560 patients were included into the evaluation and the median follow-up was 15.1 yr, with a range up to 21.4 yr. At 15 yr, CSS rates for low-, intermediate-, and high risk patients were 95%, 89%, and 65%, respectively; MFS, STFS-1 (salvage treatment other than HIFU), STFS-2 (salvage treatment including repeat HIFU), and BFFS rates were 91%, 85%, and 58%; 77%, 63%, and 29%; 67%, 52%, and 28%; and 82%, 73%, and 47%, respectively. Preoperative high-risk category was an independent predictor of inferior OS, CSS, MFS, STFS, and BFFS. Conclusions: Although whole-gland HIFU achieved good long-term cancer control in low and intermediate-risk patients, high-risk patients should not be treated routinely by HIFU. Intermediate-risk patients achieve high CSS and MFS rates, but a relevant salvage treatment rate has to be reckoned with. Long-term data after whole-gland therapy might help derive implications for focal treatment sources and patient selection. Patient summary: Long-term data after whole-gland high-intensity focused ultrasound (HIFU) therapy are crucial to prove its oncological efficacy, and may help derive implications for focal treatment strategies and patient selection. In this context, whole-gland HIFU achieved good long-term cancer control up to 21 yr in low-and intermediate-risk prostate cancer (PCa) patients. Owing to considerably inferior long-term cancer control, it should not routinely be used in high-risk PCa patients. (C) 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.
Metadata last modified: 29 Feb 2024 12:47
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