Focal High-Intensity Focused Ultrasound with intraoperative prostate compression promising for patients with localized prostate cancer: Study

A recent study published in the Prostate Cancer and Prostatic Diseases evaluated focal therapy with high-intensity focused ultrasound (HIFU) combined with intraoperative prostate compression demonstrates promising outcomes for patients with localized prostate cancer (PC). This minimally invasive treatment showed high rates of cancer control while preserving urinary and sexual functions in the medium term.

The study included a total of 240 patients with localized prostate cancer who had prostate-specific antigen (PSA) levels ≤20 ng/mL. Clinically significant prostate cancer (CSPC) was identified through advanced imaging techniques, including MRI-transrectal ultrasound fusion-guided target biopsy and a 12-core systematic biopsy. Focal HIFU therapy was directed at visible lesions identified on MRI, with biochemical failure determined using the Phoenix ASTRO criteria. Pathological failure was defined as the presence of CSPC in a biopsy performed during biochemical failure.

The participants were categorized by the D’Amico risk classification into 3 groups: low-risk (n=51), intermediate-risk (n=107), and high-risk (n=82). The patients were followed for a median of 48 months, with follow-up periods ranging from 24 to 84 months. The study reported the following outcomes:

  • Low-risk group: 93.7% biochemical disease-free survival and 92.2% pathological disease-free survival.
  • Intermediate-risk group: 88.5% biochemical disease-free survival and 91.6% pathological disease-free survival.
  • High-risk group: 84.8% biochemical disease-free survival and 86.6% pathological disease-free survival.

Urinary and sexual function were temporarily affected post-treatment, with noticeable deterioration at one month. However, both functions returned to pre-treatment levels within 3 to 6 months, underlining the ability of this treatment to minimize long-term side effects.

The findings suggest that focal HIFU therapy with intraoperative prostate compression is an effective treatment for localized prostate cancer by offering strong medium-term oncological control with minimal functional deterioration. These results are particularly promising for patients seeking alternatives to radical treatments, which often involve more significant risks of long-term complications. Overall, the study highlighted the potential of HIFU as a targeted and patient-friendly therapy for localized prostate cancer. With continued research and longer-term follow-ups, this approach could help redefine the treatment protocols for patients at varying risk levels.

Source:

Shoji, S., Naruse, J., Ohno, S., Aoki, M., Takahashi, K., Yuzuriha, S., Kuroda, S., Umemoto, T., Nakajima, N., Hasegawa, M., Kawamura, Y., Kajiwara, H., Hashida, K., Uemura, K., Hasebe, T., & Tajiri, T. (2024). Focal therapy using high-intensity focused ultrasound with intraoperative prostate compression for patients with localized prostate cancer: a multi-center prospective study with 7 year experience. In Prostate Cancer and Prostatic Diseases. Springer Science and Business Media LLC. https://doi.org/10.1038/s41391-024-00921-0

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