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Results of high intensity focused ultrasound treatment of prostate cancer: early Canadian experience at a single center.
Can J Urol. 2011 Dec; 18(6):6037-42.CJ

Abstract

INTRODUCTION

High intensity focused ultrasound (HIFU) is a non-invasive technique that uses focused ultrasound waves to ablate tissue. This retrospective study evaluates the early HIFU experience at a single Canadian center.

MATERIALS AND METHODS

Ninety-five patients were treated between March 2006 and December 2007 using the Sonablate-500 device (Focus Surgery, Indianapolis, IN, USA). Follow up occurred at 3 month intervals and included serial prostate-specific antigen (PSA) measurements, assessments of erectile function and continence rates with the international index of erectile function (IIEF) and expanded prostate cancer index composite (EPIC) questionnaires respectively. Early and late complications were also studied.

RESULTS

There were 95 patients treated by five urologists. The mean age of patients was 64 years (range 46-91). The majority of men treated had Gleason 6 (n = 53) or Gleason 7 (n = 35) disease. The remainder had Gleason 8 (n = 5) and Gleason 9 (n = 2) prostate cancer. Prostate volume in the pre-treatment group was 30.5 cc (range 14.4 cc-73 cc). Cytoreductive androgen deprivation therapy prior to treatment was administered to 10 men. Post-HIFU with a minimum 6 months follow up (mean 10.62 months), 2% (1/59) of men had de novo moderate to severe erectile dysfunction (IIEF ≤ 11). With a minimum of 6 months follow up (mean 8.85 months), 17% (7/41) of the men had significant incontinence according to their EPIC scores. Early complications included catheter-related problems (n = 10), retention (n = 16), and urosepsis (n = 1). Late complications included need for cystoscopy (n = 25), TURP (n = 6), VIU/dilatation for stricture or bladder neck contracture (n = 13) and self-catheterization (n = 1). Prostatorectal fistula occurred in one patient who had prior radiotherapy. Salvage HIFU following radiation failure was performed in seven men. Recurrence of cancer following HIFU was diagnosed in seven men. Salvage treatment included radical prostatectomy (n = 3), radiation therapy (n = 2), repeat HIFU (n = 1), hormone therapy (n = 1).

CONCLUSIONS

In our early experience HIFU treatment for prostate cancer was associated with a moderate rate of complications and failure. Further studies are required to examine long term outcomes with HIFU.

Authors+Show Affiliations

Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22166332

Citation

Elterman, Dean S., et al. "Results of High Intensity Focused Ultrasound Treatment of Prostate Cancer: Early Canadian Experience at a Single Center." The Canadian Journal of Urology, vol. 18, no. 6, 2011, pp. 6037-42.
Elterman DS, Barkin J, Radomski SB, et al. Results of high intensity focused ultrasound treatment of prostate cancer: early Canadian experience at a single center. Can J Urol. 2011;18(6):6037-42.
Elterman, D. S., Barkin, J., Radomski, S. B., Fleshner, N. E., Liu, B., Bensimon, K., Arora, S., Robinette, M., & Finelli, A. (2011). Results of high intensity focused ultrasound treatment of prostate cancer: early Canadian experience at a single center. The Canadian Journal of Urology, 18(6), 6037-42.
Elterman DS, et al. Results of High Intensity Focused Ultrasound Treatment of Prostate Cancer: Early Canadian Experience at a Single Center. Can J Urol. 2011;18(6):6037-42. PubMed PMID: 22166332.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Results of high intensity focused ultrasound treatment of prostate cancer: early Canadian experience at a single center. AU - Elterman,Dean S, AU - Barkin,Jack, AU - Radomski,Sidney B, AU - Fleshner,Neil E, AU - Liu,Brian, AU - Bensimon,Kira, AU - Arora,Samantha, AU - Robinette,Michael, AU - Finelli,Antonio, PY - 2011/12/15/entrez PY - 2011/12/15/pubmed PY - 2012/4/27/medline SP - 6037 EP - 42 JF - The Canadian journal of urology JO - Can J Urol VL - 18 IS - 6 N2 - INTRODUCTION: High intensity focused ultrasound (HIFU) is a non-invasive technique that uses focused ultrasound waves to ablate tissue. This retrospective study evaluates the early HIFU experience at a single Canadian center. MATERIALS AND METHODS: Ninety-five patients were treated between March 2006 and December 2007 using the Sonablate-500 device (Focus Surgery, Indianapolis, IN, USA). Follow up occurred at 3 month intervals and included serial prostate-specific antigen (PSA) measurements, assessments of erectile function and continence rates with the international index of erectile function (IIEF) and expanded prostate cancer index composite (EPIC) questionnaires respectively. Early and late complications were also studied. RESULTS: There were 95 patients treated by five urologists. The mean age of patients was 64 years (range 46-91). The majority of men treated had Gleason 6 (n = 53) or Gleason 7 (n = 35) disease. The remainder had Gleason 8 (n = 5) and Gleason 9 (n = 2) prostate cancer. Prostate volume in the pre-treatment group was 30.5 cc (range 14.4 cc-73 cc). Cytoreductive androgen deprivation therapy prior to treatment was administered to 10 men. Post-HIFU with a minimum 6 months follow up (mean 10.62 months), 2% (1/59) of men had de novo moderate to severe erectile dysfunction (IIEF ≤ 11). With a minimum of 6 months follow up (mean 8.85 months), 17% (7/41) of the men had significant incontinence according to their EPIC scores. Early complications included catheter-related problems (n = 10), retention (n = 16), and urosepsis (n = 1). Late complications included need for cystoscopy (n = 25), TURP (n = 6), VIU/dilatation for stricture or bladder neck contracture (n = 13) and self-catheterization (n = 1). Prostatorectal fistula occurred in one patient who had prior radiotherapy. Salvage HIFU following radiation failure was performed in seven men. Recurrence of cancer following HIFU was diagnosed in seven men. Salvage treatment included radical prostatectomy (n = 3), radiation therapy (n = 2), repeat HIFU (n = 1), hormone therapy (n = 1). CONCLUSIONS: In our early experience HIFU treatment for prostate cancer was associated with a moderate rate of complications and failure. Further studies are required to examine long term outcomes with HIFU. SN - 1195-9479 UR - https://www.unboundmedicine.com/medline/citation/22166332/Results_of_high_intensity_focused_ultrasound_treatment_of_prostate_cancer:_early_Canadian_experience_at_a_single_center_ L2 - http://www.canjurol.com/abstract.php?ArticleID=&version=1.0&PMID=22166332 DB - PRIME DP - Unbound Medicine ER -