MP46-09 FOCAL HIFU TREATMENT OF APICAL LESION: SAFETY AND ONCOLOGICAL RESULTS

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy (MP46)1 Sep 2021MP46-09 FOCAL HIFU TREATMENT OF APICAL LESION: SAFETY AND ONCOLOGICAL RESULTS Crouzet Sebastien, Gelet Albert, Thomas Hostiou, Rouvière Olivier, Badet Lionel, Stefano Regusci, and Martina Martins Crouzet SebastienCrouzet Sebastien More articles by this author , Gelet AlbertGelet Albert More articles by this author , Thomas HostiouThomas Hostiou More articles by this author , Rouvière OlivierRouvière Olivier More articles by this author , Badet LionelBadet Lionel More articles by this author , Stefano RegusciStefano Regusci More articles by this author , and Martina MartinsMartina Martins More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002067.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To assess and compare safety, oncological, functional and quality-of-life (QoL) outcomes of focal ablation with high intensity focalized ultrasound (HIFU) of apical prostate cancer (PCa) lesions in comparison to other localization. METHODS: In this retrospection analysis, patients with apical tumor lesion (AL) were compared to patients without any lesion in this area (control-group: CG). Treatments were delivered using Ablatherm or Focal One devices with either hemi, focal or multifocal HIFU ablation as a first-line treatment strategy. Functional and quality of life outcomes were evaluated using IPSS, IIEF-5, ICS and QLC-30 questionnaires that were addressed to patients included in several clinical studies. Continence was considered as the use of no pads. Oncological follow up included 3-month PSA levels, mpMRI at 6 months and biopsy at 1-year post treatment. The failure was defined as either ISUP2 positive biopsy, salvage treatment, metastasis or death due to Pca. RESULTS: From November 2009 to November 2018, a total of 171 patients were included (57 patients (33%) were assigned to AL vs 114 patients (67%) to CG. Mean age was 67 years, mean PSA was 7.1 ng/mL, including 94 (55%) ISUP-1 and 77 (45%) ISUP-2 cancer. No difference was observed between the two groups on these criteria. The mean number of positive biopsies was the only significant pre-treatment difference (3.8 in AL vs 2.5 in CG, p<0.001). Treatment were delivered with Ablatherm (19%) and Focal One device (81%). Different strategies, hemi, focal and multifocal were used, in 54% 39% and 7% in AL and 42%, 55% and 3% in CG patients, respectively. Contrast Enhanced Ultrasound was used in a significantly higher proportion of patients (87% in AL vs 73% in CG, p=0.04) with a treatment completion necessary in a significantly higher proportion of patients in AL and CG: 64% vs 40% respectively, p=0.004). Control biopsy was performed in 49 patients (86%) in the AL vs 97 (85%) in the CG. The in-field positive biopsy rate was not significantly different with 45% in AL vs 37% in CG respectively (p=0.364). At 5-years, the failure-free survival rate was 66% in AL vs 65% in CG (p=0.328). The IPSS, ICS and QLC30 were not different after treatment for both group. However, the decrease of IIEF 5 score induced by the treatment was significantly higher for AL (p=0.008). CONCLUSIONS: Although challenging, the apical lesion can be securely and effectively treated by focal HIFU with similar oncological results than other cancer localization within the prostate. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e816-e816 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Crouzet Sebastien More articles by this author Gelet Albert More articles by this author Thomas Hostiou More articles by this author Rouvière Olivier More articles by this author Badet Lionel More articles by this author Stefano Regusci More articles by this author Martina Martins More articles by this author Expand All Advertisement Loading ...