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Prog Urol. 2019 Aug 7. pii: S1166-7087(19)30155-1. doi: 10.1016/j.purol.2019.06.004. [Epub ahead of print]

Salvage Hemiablation High Intensity Focused Ultrasound for unilateral radio-recurrent prostate cancer.

Author information

1
Service d'Urologie, Institut Jules-Bordet, Université Libre de Bruxelles, Bruxelles, Belgique; Service d'Urologie, Hôtel Dieu de France, Faculté de médecine - Université Saint-Joseph, Beyrouth, Liban. Electronic address: fouad.aoun@bordet.be.
2
Service d'Urologie, Cliniques Universitaires de Bruxelles, hôpital Erasme, Université Libre de Bruxelles, Bruxelles, Belgique.
3
Service d'Urologie, Institut Jules-Bordet, Université Libre de Bruxelles, Bruxelles, Belgique.

Abstract

OBJECTIVE:

To report the oncological and functional outcomes of salvage hemiablation high-intensity focused ultrasound (HIFU) in patients with unilateral radio-recurrent prostate cancer.

PATIENTS AND METHODS:

Patients with biochemical recurrence (BCR) after primary radiation therapy and evidence of unilateral organ confined recurrence based on a complete match between mpMRI and MRI targeted biopsies were included. Patients with distant metastasis were excluded. Patients were followed with serial serum PSA determinations. BCR were defined using the Phoenix criteria. Complications were graded according to the Clavien score. IIEF-5 questionnaire was used to assess erectile dysfunction. Urinary incontinence was reported using physician reported rates.

RESULTS:

A total of 10 consecutive patients (median age: 71 years, IQR: 69-76) were prospectively enrolled. The median pre-treatment PSA and post-treatment PSA nadir were 3.1ng/mL (IQR: 1.54-8.59) and 1.52ng/mL (IQR: 0.76-2.2), respectively. At a median follow-up of 41.5 (IQR: 18-58) months, 50% of patients experience BCR. BCR free-survival rates at 24 and 36 months were 75% (CI95%: 31-93) and 60% (CI95%: 20-85), respectively. Urinary in continence grade II occurred in two patients and the remaining patients were pad-free. One patient developed de novo erectile dysfunction requiring PDE5I. The erectile function scores decreased from a mean of 10.1 to 8.7.

CONCLUSION:

Hemiablation HIFU is an alternative to whole gland therapy in patients with unilateral radio- recurrent prostate cancer, which offers limited urinary and rectal morbidity, and preserves functional outcomes.

LEVEL OF EVIDENCE:

3.

KEYWORDS:

Cancer prostate; Functional outcomes; HIFU; Hemiablation; High-intensity focused ultrasound (HIFU); Hémiablation; Local recurrence; Oncological outcomes; Prostate cancer; Radiotherapy; Radiothérapie; Salvage treatment; Traitement de sauvetage

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