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Treatment of localized prostate cancer using high-intensity focused ultrasound.
BJU Int. 2006 Jan; 97(1):56-61.BI

Abstract

OBJECTIVE

To evaluate the biochemical disease-free survival (DFS), predictors of clinical outcome and morbidity of patients with localized prostate cancer treated with high-intensity focused ultrasound (HIFU), a noninvasive treatment that induces complete coagulative necrosis of a tumour at depth through the intact skin.

PATIENTS AND METHODS

In all, 63 patients with stage T1c-2bN0M0 localized prostate cancer underwent HIFU using the Sonablate system (Focus Surgery, Inc., Indianapolis, IN, USA). None of the patients received neoadjuvant and/or adjuvant therapy. Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology consensus definition, i.e. three consecutive increases in prostate-specific antigen (PSA) level after the nadir. The median (range) age, PSA level and follow-up were 71 (45-87) years, 8.5 (3.39-57.0) ng/mL and 22.0 (3-63) months, respectively.

RESULTS

The overall biochemical disease-free rate was 75% (47 patients). The 3-year biochemical DFS rates for patients with a PSA level before HIFU of <10, 10.01-20 and >20 ng/mL were 82%, 62% and 20% (P < 0.001), respectively. The 3-year biochemical DFS rates for patients with a PSA nadir of <0.2, 0.21-1 and >1 ng/mL were 100%, 74% and 21% (P < 0.001), respectively. Final follow-up sextant biopsies showed that 55 (87%) of the patients were cancer-free. Multivariate analysis showed that the PSA nadir (P < 0.001) was a significant independent predictor of relapse.

CONCLUSION

HIFU therapy appears to be a safe, effective and minimally invasive therapy for patients with localized prostate cancer, and the PSA nadir is a useful predictor of clinical outcome.

Authors+Show Affiliations

University of Tokai Hachioji Hospital, Hachioji, Japan. tuchida@green.ocn.ne.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

16336329

Citation

Uchida, Toyoaki, et al. "Treatment of Localized Prostate Cancer Using High-intensity Focused Ultrasound." BJU International, vol. 97, no. 1, 2006, pp. 56-61.
Uchida T, Ohkusa H, Nagata Y, et al. Treatment of localized prostate cancer using high-intensity focused ultrasound. BJU Int. 2006;97(1):56-61.
Uchida, T., Ohkusa, H., Nagata, Y., Hyodo, T., Satoh, T., & Irie, A. (2006). Treatment of localized prostate cancer using high-intensity focused ultrasound. BJU International, 97(1), 56-61.
Uchida T, et al. Treatment of Localized Prostate Cancer Using High-intensity Focused Ultrasound. BJU Int. 2006;97(1):56-61. PubMed PMID: 16336329.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of localized prostate cancer using high-intensity focused ultrasound. AU - Uchida,Toyoaki, AU - Ohkusa,Hiroshi, AU - Nagata,Yasunori, AU - Hyodo,Toru, AU - Satoh,Takefumi, AU - Irie,Akira, PY - 2005/12/13/pubmed PY - 2006/1/24/medline PY - 2005/12/13/entrez SP - 56 EP - 61 JF - BJU international JO - BJU Int VL - 97 IS - 1 N2 - OBJECTIVE: To evaluate the biochemical disease-free survival (DFS), predictors of clinical outcome and morbidity of patients with localized prostate cancer treated with high-intensity focused ultrasound (HIFU), a noninvasive treatment that induces complete coagulative necrosis of a tumour at depth through the intact skin. PATIENTS AND METHODS: In all, 63 patients with stage T1c-2bN0M0 localized prostate cancer underwent HIFU using the Sonablate system (Focus Surgery, Inc., Indianapolis, IN, USA). None of the patients received neoadjuvant and/or adjuvant therapy. Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology consensus definition, i.e. three consecutive increases in prostate-specific antigen (PSA) level after the nadir. The median (range) age, PSA level and follow-up were 71 (45-87) years, 8.5 (3.39-57.0) ng/mL and 22.0 (3-63) months, respectively. RESULTS: The overall biochemical disease-free rate was 75% (47 patients). The 3-year biochemical DFS rates for patients with a PSA level before HIFU of <10, 10.01-20 and >20 ng/mL were 82%, 62% and 20% (P < 0.001), respectively. The 3-year biochemical DFS rates for patients with a PSA nadir of <0.2, 0.21-1 and >1 ng/mL were 100%, 74% and 21% (P < 0.001), respectively. Final follow-up sextant biopsies showed that 55 (87%) of the patients were cancer-free. Multivariate analysis showed that the PSA nadir (P < 0.001) was a significant independent predictor of relapse. CONCLUSION: HIFU therapy appears to be a safe, effective and minimally invasive therapy for patients with localized prostate cancer, and the PSA nadir is a useful predictor of clinical outcome. SN - 1464-4096 UR - https://www.unboundmedicine.com/medline/citation/16336329/Treatment_of_localized_prostate_cancer_using_high_intensity_focused_ultrasound_ L2 - https://doi.org/10.1111/j.1464-410X.2006.05864.x DB - PRIME DP - Unbound Medicine ER -