MP30-10 HIFU DOSE ESCALATION LEADS TO FEWER RECURRENCES IN FOLLOWING FOCAL HIFU IN PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I1 Apr 2018MP30-10 HIFU DOSE ESCALATION LEADS TO FEWER RECURRENCES IN FOLLOWING FOCAL HIFU IN PROSTATE CANCER Philipp M. Huber, Naveed Afzal, Manit Arya, Silvan Boxler, Susan Charman, Andrew Cornaby, Tim Dudderidge, Mark Emberton, Stephanie Guillaumier, Richard J. Hindley, Lucas Leemann, Henry Lewi, Neil McCartan, Caroline M. Moore, Raj Nigam, Chris Ogden, Raj Persad, Karishma Shah, George N. Thalmann, Jaspal Virdi, Mathias Winkler, and Hashim U. Ahmed Philipp M. HuberPhilipp M. Huber More articles by this author , Naveed AfzalNaveed Afzal More articles by this author , Manit AryaManit Arya More articles by this author , Silvan BoxlerSilvan Boxler More articles by this author , Susan CharmanSusan Charman More articles by this author , Andrew CornabyAndrew Cornaby More articles by this author , Tim DudderidgeTim Dudderidge More articles by this author , Mark EmbertonMark Emberton More articles by this author , Stephanie GuillaumierStephanie Guillaumier More articles by this author , Richard J. HindleyRichard J. Hindley More articles by this author , Lucas LeemannLucas Leemann More articles by this author , Henry LewiHenry Lewi More articles by this author , Neil McCartanNeil McCartan More articles by this author , Caroline M. MooreCaroline M. Moore More articles by this author , Raj NigamRaj Nigam More articles by this author , Chris OgdenChris Ogden More articles by this author , Raj PersadRaj Persad More articles by this author , Karishma ShahKarishma Shah More articles by this author , George N. ThalmannGeorge N. Thalmann More articles by this author , Jaspal VirdiJaspal Virdi More articles by this author , Mathias WinklerMathias Winkler More articles by this author , and Hashim U. AhmedHashim U. Ahmed More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.951AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To determine if delivering greater amounts of focused Ultrasound heat energy when treating non-metastatic prostate cancer using focal HIFU leads to lower recurrence rates. METHODS Based on the prospectively maintained HIFU (Sonablate 500) registry cases were identified who underwent a focal HIFU (03/2007 to 12/2016) with standard HIFU delivery or dose-escalated HIFU. In-field treamtent failure was defined by any secondary treatment (ADT/chemotherapy, cryotherapy, EBRT, RRP, or re-HIFU), metastasis from prostate cancer without further treatment, tumour recurrence with Gleason score ≥7 on prostate biopsy, or death from prostate cancer, respectively. 131 cases were treated with two, and 59 cases with three ablative zones respectively and could be used for a matched-pair analysis. Two major criteria were used for mandatory exact matching (baseline Gleason score and mpMRI-defined tumour volume). Other criteria (biopsy maximum cancer core length (MCCL), duration of clinical follow-up, and time to proof of recurrence) were also used and nearest matching accepted. 37 matched pairs were identified. Statistics by R-language. RESULTS In the standard HIFU and dose-escalated groups, respectively, PSA (IQR) was 7.18ng/ml (4.6-10.3) and 6.7ng/ml (5.37-8.5), mean prostate volume (range) was 46ml (17-103) and 52ml (19-121), mean tumour volume (range) in both groups were identical at 0.6ml (0.05-2.5). For the two groups, respectively, median biopsy results (IQR) for number of positive cores, MCCL (in cm), and maximal percentage of core were 6 (3-8) vs. 4 (3-5), 6 (4-9) vs. 5 (4-8), and 65 (40-80) vs. 50 (30-67). Gleason score (% of cases) was 3+3=6 in 2/37 (5%), 3+4 in 31/37 (84%), and 4+3 in 4/37 (11%). Median time elapsed until in-field failure was proven (IQR) was 13 month (11.5-24) compared to 11.5 month (9.5-13). Overall, in-field recurrence (%) was found in 11/37 (29.7%) in standard HIFU and 6/37 (16.2%) in dose-escalated HIFU (p=0.002). CONCLUSIONS Significantly higher rate of in-field treatment failure in focal HIFU using the standard HIFU protocol on the Sonablate 500 compared to a dose-escalation by delivering more energy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e378 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Philipp M. Huber More articles by this author Naveed Afzal More articles by this author Manit Arya More articles by this author Silvan Boxler More articles by this author Susan Charman More articles by this author Andrew Cornaby More articles by this author Tim Dudderidge More articles by this author Mark Emberton More articles by this author Stephanie Guillaumier More articles by this author Richard J. Hindley More articles by this author Lucas Leemann More articles by this author Henry Lewi More articles by this author Neil McCartan More articles by this author Caroline M. Moore More articles by this author Raj Nigam More articles by this author Chris Ogden More articles by this author Raj Persad More articles by this author Karishma Shah More articles by this author George N. Thalmann More articles by this author Jaspal Virdi More articles by this author Mathias Winkler More articles by this author Hashim U. Ahmed More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...