eprintid: 57078 rev_number: 1 eprint_status: archive userid: 3883 dir: documents_old/00/05/70/78 datestamp: 2024-02-29 12:47:18 lastmod: 2024-02-29 12:47:18 status_changed: 2024-02-29 12:47:18 type: article metadata_visibility: show contact_email: johannes.bruendl@ukr.de creators_name: Bründl, Johannes creators_name: Osberghaus, Vera creators_name: Zeman, Florian creators_name: Breyer, Johannes creators_name: Ganzer, Roman creators_name: Blana, Andreas creators_name: Gierth, Michael creators_name: Denzinger, Stefan creators_name: Burger, Maximilian creators_name: Rosenhammer, Bernd title: Oncological Long-term Outcome After Whole-gland High-intensity Focused Ultrasound for Prostate Cancer—21-yr Follow-up ispublished: pub subjects: ddc_2_610 institutions: fak04_30 institutions: fak04_33_01 full_text_status: none keywords: RADICAL PROSTATECTOMY; THERAPY; High-intensity focused; ultrasound; Oncological outcome; Long term; Prostate cancer 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. date_type: published date_online: 2022 date: 2022 publication: European Urology Focus volume: 8 number: 1 publisher: Elsevier place_of_pub: AMSTERDAM pagerange: 134-140 id_number_name: 10.1016/j.euf.2020.12.016 id_number_type: doi refereed: yes created_here: yes issn: 2405-4569 official_url: http://doi.org/10.1016/j.euf.2020.12.016 referencetext: Bill-Axelson A, 2018, NEW ENGL J MED, V379, P2319, DOI 10.1056/NEJMoa1807801 Blana A, 2009, BJU INT, V104, P1058, DOI 10.1111/j.1464-410X.2009.08518.x Chaussy CG, 2017, J ENDOUROL, V31, pS30, DOI 10.1089/end.2016.0548 Cornford P, 2017, EUR UROL, V71, P630, DOI 10.1016/j.eururo.2016.08.002 Crouzet S, 2014, EUR UROL, V65, P907, DOI 10.1016/j.eururo.2013.04.039 Crouzet S, 2010, EUR UROL, V58, P559, DOI 10.1016/j.eururo.2010.06.037 D'Amico AV, 1998, JAMA-J AM MED ASSOC, V280, P969, DOI 10.1001/jama.280.11.969 Dickinson L, 2016, EUR UROL, V70, P668, DOI 10.1016/j.eururo.2016.02.054 Fitzmaurice C, 2018, JAMA ONCOL, V4, P1553, DOI 10.1001/jamaoncol.2018.2706 Ganzer R, 2018, PROSTATE CANCER P D, V21, P175, DOI 10.1038/s41391-018-0042-0 Ganzer R, 2013, BJU INT, V112, P322, DOI 10.1111/j.1464-410X.2012.11715.x Guillaumier S, 2018, EUR UROL, V74, P422, DOI 10.1016/j.eururo.2018.06.006 Hamdy FC, 2016, NEW ENGL J MED, V375, P1415, DOI 10.1056/NEJMoa1606220 Maurer T, 2019, EUR UROL, V75, P659, DOI 10.1016/j.eururo.2018.03.013 Roach M, 2006, INT J RADIAT ONCOL, V65, P965, DOI 10.1016/j.ijrobp.2006.04.029 Rosenhammer B, 2019, WORLD J UROL, V37, P2073, DOI 10.1007/s00345-018-2613-z Shah TT, 2019, EUR UROL, V76, P98, DOI 10.1016/j.eururo.2018.12.030 Stabile A, 2019, BJU INT, V124, P431, DOI 10.1111/bju.14710 Thuroff S, 2013, J UROLOGY, V190, P702, DOI 10.1016/j.juro.2013.02.010 Tourinho-Barbosa RR, 2020, J UROLOGY, V203, P320, DOI 10.1097/JU.0000000000000506 van der Poel HG, 2018, EUR UROL, V74, P84, DOI 10.1016/j.eururo.2018.01.001 Wilt TJ, 2017, NEW ENGL J MED, V377, P132, DOI 10.1056/NEJMoa1615869 author_address: [Bruendl, Johannes; Osberghaus, Vera; Breyer, Johannes; Gierth, Michael; Denzinger, Stefan; Burger, Maximilian; Rosenhammer, Bernd] Univ Regensburg, Dept Urol, Caritas St Josef Med Ctr, Landshuter Str 65, D-93053 Regensburg, Germany; [Zeman, Florian] Univ Hosp Regensburg, Ctr Clin Studies, Regensburg, Germany; [Ganzer, Roman] Asklepios Hosp Bad Tolz, Dept Urol, Bad Tolz, Germany; [Blana, Andreas] Furth Hosp, Dept Urol, Furth, Germany reprint_address: Brundl, J (corresponding author), Univ Regensburg, Dept Urol, Caritas St Josef Med Ctr, Landshuter Str 65, D-93053 Regensburg, Germany. funder_text: | pubmed_id: 33483288 doi: 10.1016/j.euf.2020.12.016 wok_id: 2023-06-27 publication_abbrev: EUR UROL FOCUS publication_iso: Eur. Urol. Focus wos_categories: Urology & Nephrology research_areas: Urology & Nephrology oa_access: Bronze cor_ur: hospital doaj: doaj_without_apc fp7_project: no fp7_type: info:eu-repo/semantics/article citation: Bründl, Johannes, Osberghaus, Vera, Zeman, Florian, Breyer, Johannes, Ganzer, Roman, Blana, Andreas, Gierth, Michael, Denzinger, Stefan, Burger, Maximilian und Rosenhammer, Bernd (2022) Oncological Long-term Outcome After Whole-gland High-intensity Focused Ultrasound for Prostate Cancer—21-yr Follow-up. European Urology Focus 8 (1), S. 134-140.