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Focal high-intensity focused ultrasound therapy for localized prostate cancer: An interim analysis of the multinational FASST study
S. Ladjevardi, A. Ebner, A. Femic, NA. Huebner, SF. Shariat, S. Kraler, RA. Kubik-Huch, RC. Ahlman, M. Häggman, LJ. Hefermehl
Jazyk angličtina Země Anglie, Velká Británie
Typ dokumentu časopisecké články, multicentrická studie
PubMed
38445798
DOI
10.1111/eci.14192
Knihovny.cz E-zdroje
- MeSH
- ablace intenzivním ultrazvukovým paprskem metody MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- multiparametrická magnetická rezonance MeSH
- nádory prostaty * terapie patologie MeSH
- neúspěšná terapie MeSH
- proporcionální rizikové modely MeSH
- prospektivní studie MeSH
- prostatický specifický antigen * metabolismus krev MeSH
- senioři MeSH
- stupeň nádoru MeSH
- transrektální ultrazvuk o vysoké intenzitě MeSH
- záchranná terapie metody MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
BACKGROUND: High-intensity focused ultrasound (HIFU) emerged as a novel approach for the treatment of localized prostate cancer (PCa). However, prospective studies on HIFU-related outcomes and predictors of treatment failure (TF) remain scarce. MATERIALS AND METHODS: We conducted a multinational prospective cohort study among patients undergoing HIFU therapy for localized, low- to intermediate-risk PCa. Follow-up data on serial prostate specific antigen (PSA), multi-parametric magnetic resonance imaging (mpMRI), targeted/systematic biopsies, adverse events and functional outcomes were collected. The primary endpoint was TF, defined as histologically confirmed PCa requiring whole-gland salvage treatment. Uni- and multi-variable adjusted hazard ratios (HRs) were calculated using Cox proportional hazard regression models. RESULTS: At baseline, mean (standard deviation) age was 64.14 (7.19) years, with the majority of patients showing T-stage 1 (73.9%) and International Society of Urological Pathology grading system Grade 2 (58.8%). PSA nadir (median, 1.70 ng/mL) was reached after 6 months. Of all patients recruited, 16% had clinically significant PCa, as confirmed by biopsy, of which 13.4% had TF. Notably, T-stage and number of positive cores at initial biopsy were independent predictors of TF during follow-up (HR [95% CI] 1.27 [1.02-1.59] and 5.02 [1.80-14.03], respectively). Adverse events were minimal (17% and 8% early and late adverse events, respectively), with stable or improved functional outcomes in the majority of patients. CONCLUSIONS: This interim analysis of a multinational study on HIFU therapy for the management of low-to-intermediate-risk PCa reveals good functional outcomes, minimal adverse events and low incidence of TF over the short-term. Data on long-term outcomes, specifically as it relates to oncological outcomes, are awaited eagerly.
Center for Molecular Cardiology University of Zurich Schlieren Switzerland
Department of Internal Medicine Cantonal Hospital Baden Baden Switzerland
Department of Radiology Cantonal Hospital Baden Baden Switzerland
Department of Urology 2nd Faculty of Medicine Charles University Prague Czech Republic
Department of Urology Cantonal Hospital Baden Baden Switzerland
Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria
Department of Urology University Hospital Zurich Zurich Switzerland
Department of urology University of California Davis Sacramento California USA
Department of Urology University of Texas Southwestern Dallas Texas USA
Department of Urology University of Uppsala Uppsala Sweden
Department of Urology Weill Cornell Medical College New York New York USA
Karl Landsteiner Institute of Urology and Andrology Vienna Austria
Working Group for Diagnostic imaging in Urology Vienna Austria
Citace poskytuje Crossref.org
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- $a BACKGROUND: High-intensity focused ultrasound (HIFU) emerged as a novel approach for the treatment of localized prostate cancer (PCa). However, prospective studies on HIFU-related outcomes and predictors of treatment failure (TF) remain scarce. MATERIALS AND METHODS: We conducted a multinational prospective cohort study among patients undergoing HIFU therapy for localized, low- to intermediate-risk PCa. Follow-up data on serial prostate specific antigen (PSA), multi-parametric magnetic resonance imaging (mpMRI), targeted/systematic biopsies, adverse events and functional outcomes were collected. The primary endpoint was TF, defined as histologically confirmed PCa requiring whole-gland salvage treatment. Uni- and multi-variable adjusted hazard ratios (HRs) were calculated using Cox proportional hazard regression models. RESULTS: At baseline, mean (standard deviation) age was 64.14 (7.19) years, with the majority of patients showing T-stage 1 (73.9%) and International Society of Urological Pathology grading system Grade 2 (58.8%). PSA nadir (median, 1.70 ng/mL) was reached after 6 months. Of all patients recruited, 16% had clinically significant PCa, as confirmed by biopsy, of which 13.4% had TF. Notably, T-stage and number of positive cores at initial biopsy were independent predictors of TF during follow-up (HR [95% CI] 1.27 [1.02-1.59] and 5.02 [1.80-14.03], respectively). Adverse events were minimal (17% and 8% early and late adverse events, respectively), with stable or improved functional outcomes in the majority of patients. CONCLUSIONS: This interim analysis of a multinational study on HIFU therapy for the management of low-to-intermediate-risk PCa reveals good functional outcomes, minimal adverse events and low incidence of TF over the short-term. Data on long-term outcomes, specifically as it relates to oncological outcomes, are awaited eagerly.
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