Focal therapy with high-intensity focused ultrasound for localized prostate cancer : clinical outcomes of 180 patients

• Published in: Japanese Journal of Endourology and Robotics Vol. 36; no. 1; pp. 140 - 145
• Main Authors: 小路 直, 西川 大智, 藤間 萌子, 小田 和也, 鹿野 竜生, 黒田 悟史, 小川 貴博, 梅本 達哉, 中野 まゆら, 川上 正能, 新田 正広, 長谷川 政徳, 宮嶋 哲
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Endourology and Robotics 2023; 一般社団法人 日本泌尿器内視鏡・ロボティクス学会
• Subjects: Focal Therapy; 前立腺癌; 性機能; 排尿機能; 高密度焦点式超音波療法
• ISSN: 2436-875X
• DOI: 10.11302/jserjje.36.1_140

【Objectives】The objective of this study is to evaluate clinical outcomes of focal therapy with high-intensity focused ultrasound (HIFU) for localized prostate cancer (PC). 【Patients and Methods】Patients with localized PC, and serum PSA levels of ≦20 ng/mL, had their significant tumors located using magnetic resonance imaging-transrectal ultrasound elastic fusion image-guided transperineal prostate biopsy and 12-cores transperineal template-guided systematic biopsy was performed. These regions were focally treated in which the tumors were located in the prostate using transrectal HIFU. 【Results】One hundred eighty patients were included in the study. Their median age and PSA level was 70 years and 7.11 ng/mL, respectively. Patients’ risk classification was as follows, low : n＝48, intermediate : n＝62, and high : n＝70. Median HIFU ablation time was 24 minutes. Catheterization and hospitalization was within 24 hours post treatment in all patients. Biochemical disease-free rate was 91.7％ during the median follow-up period of 24 months as per the Phoenix ASTRO definition. Urinary function, including IPSS (P＝0.012), OABSS (P＝0.010), maximum urinary flow rate (P＝0.018), and IIEF-5 (P＝0.022), had significantly deteriorated at 1 month after treatment, but improved to preoperative levels at the 3-month follow-up. Rate of erectile dysfunction was determined to be 24％ , 12 months after treatment. 【Conclusions】This clinical outcome focal therapy for localized PC in Asian population showed promising long-term results. However, further large scale cohort studies are required to verify and validate these oncological and functional findings for patients with localized PC.