Abstract
We report medium-term results in men receiving primary whole-gland HIFU (WG-HIFU) and following salvage treatment. One hundred and twenty-eight patients in a single hospital were enrolled. The enrolled patients were treated with WG-HIFU for primary localized prostate cancer. Salvage treatment include androgen deprivation therapy, secondary HIFU and salvage radiation therapy. Our primary outcomes were biochemical recurrence-free survival, salvage treatment-free survival, and metastasis-free survival. Secondary outcomes included urinary incontinence, de novo erectile dysfunction, acute epididymitis, bladder neck contracture, and urethral stricture. The 5-year biochemical recurrence-free survival rates were 85.7%, 82.7%, and 45.2% for D'Amico low-, intermediate-, and high-risk groups, respectively. Multivariate analysis revealed high risk group is the only predictor of significant shorter biochemical recurrence free survival, salvage treatment free survival, and metastasis free survival. Of 38 patients receiving salvage treatment after biochemical recurrence, 29 (76.3%) became free from biochemical recurrence. Rates of the adverse events of urinary incontinence, acute epididymitis, bladder neck contracture or urethral stricture, and de novo erectile dysfunction were 2.3%, 10.9%, 20.3%, 65.6%, respectively. In conclusion, WG-HIFU is an effective treatment option for localised prostate cancer, especially in D'Amico low- and intermediate-risk cases. The success rate of salvage treatment with radiation therapy and secondary HIFU for biochemical recurrence was acceptable. Fewer adverse events were caused by HIFU, especially incontinence and erectile dysfunction, than by radical prostatectomy and radiotherapy.
Highlights
The incidence of prostate cancer in Taiwan, lower than that in Western countries, has been increasing
We present our findings on the functional and medium-term oncological outcomes from our cohort study of men with localised prostate cancer who were treated with primary whole-gland highintensity focused ultrasound (HIFU) (WG-HIFU)
Our institutional protocol for follow-up after HIFU is based on the 3-monthly postoperative prostate-specific antigen (PSA) level
Summary
The incidence of prostate cancer in Taiwan, lower than that in Western countries, has been increasing. The established and definitive treatment for localised prostate cancer includes radical prostatectomy and radiotherapy; data on long-term outcomes of both treatments are available. Invasive treatment modalities such as cryosurgical ablation of prostate and highintensity focused ultrasound (HIFU) have been developed for patients with localised prostate cancer [5, 6]. Long-term prospective comparative data on oncological outcomes after primary WG-HIFU are scarce [8]. Data on outcomes of salvage treatment after primary HIFU for localised prostate cancer are scarce. We present our findings on the functional and medium-term oncological outcomes from our cohort study of men with localised prostate cancer who were treated with primary WG-HIFU. Outcomes of salvage treatment with radiotherapy and secondary HIFU are presented
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call