MP55-08 HIGH INTENSITY FOCUSED ULTRASOUND AND CRYOABLATION FOCAL THERAPY FOR INTERMEDIATE RISK PROSTATE CANCER: ONCOLOGIC AND FUNCTIONAL OUTCOMES

Abstract

You have accessJournal of UrologyCME1 May 2022MP55-08 HIGH INTENSITY FOCUSED ULTRASOUND AND CRYOABLATION FOCAL THERAPY FOR INTERMEDIATE RISK PROSTATE CANCER: ONCOLOGIC AND FUNCTIONAL OUTCOMES Masatomo Kaneko, Alireza Ghoreifi, Samuel Peretsman, Dordaneh Sugano, Giovanni Cacciamani, Amir Lebastchi, Suzanne Palmer, Manju Aron, Osamu Ukimura, Inderbir Gill, and Andre Abreu Masatomo KanekoMasatomo Kaneko More articles by this author , Alireza GhoreifiAlireza Ghoreifi More articles by this author , Samuel PeretsmanSamuel Peretsman More articles by this author , Dordaneh SuganoDordaneh Sugano More articles by this author , Giovanni CacciamaniGiovanni Cacciamani More articles by this author , Amir LebastchiAmir Lebastchi More articles by this author , Suzanne PalmerSuzanne Palmer More articles by this author , Manju AronManju Aron More articles by this author , Osamu UkimuraOsamu Ukimura More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Andre AbreuAndre Abreu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002634.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate oncologic and functional outcomes following High Intensity Focused Ultrasound (HIFU) and Cryoablation (CRYO) focal therapy (FT) for localized prostate cancer (PCa). METHODS: We identified consecutive patients who underwent hemi-gland HIFU (h-HIFU) or hemi-gland CRYO (h-CRYO) FT as primary treatment for D’Amico intermediate risk PCa (IRB# HS-17-00749). Patients were selected by 12-core systematic and target biopsy and had unilateral index lesion. Follow up biopsy (FU-PBx) was performed from 6-12M and every 2Y thereafter. Primary endpoint was Treatment Failure (TF) defined as radical (any whole-gland) treatment, systemic therapy, metastases, or PCa-specific mortality. Secondary endpoints were survival-free from i) biochemical failure (BF, PSA nadir+2 ng/mL); ii) Grade Group (GG) ≥2 on FU-PBx, iii) repeat FT, iv) radical treatment, and v) systemic therapy. Kaplan-Meier method was used for survival evaluation. International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-5) and continence (zero pad) were also evaluated. Statistically significant if p <0.05. RESULTS: 184 patients met inclusion criteria: 121 (66%) h-CRYO and 63 (34%) h-HIFU. The baseline characteristics were comparable among h-HIFU vs h-CRYO, respectively, as follows: median age (65 vs 67 Y, p =0.15), PSA (5.9 vs 6.7 ng/mL, p = 0.081), PSA density (0.18 vs 0.17 ng/mL2, p = 0.61), number of positive cores (3 vs 3, p=0.14) and maximum PCa core % (50% vs 50%, p=0.59). h-CRYO had higher rate of GG3, as follows: GG1 (2% vs 7%), GG2 (79% vs 50%) and GG3 (19% vs 42%); p <0.001. The median follow up was longer for h-CRYO (30 M) vs h-HIFU (24M); p=0.005. PSA nadir was 1.1 ng/mL for h-HIFU vs 0.91 ng/mL for h-CRYO, p=0.53. The 3-year TF-free survival was: 88% for h-HIFU and 95% for h-CRYO, p=0.32. The 3-year free survival was, for h-HIFU vs h-CRYO, respectively: BF (80% vs 70%, p=0.89); GG≥2 on FU-PBx (63% vs 90%, p <0.001), repeat FT (93% vs 98%, p=0.40), radical treatment (87% vs 99%, p=0.04) and systemic therapy (100% vs 96%, p=0.23). One patient on h-CRYO developed bone metastases, but no patient died. Median difference from pre- to post-FT IPSS (0 vs 1.5; p=0.99) and IIEF-5 (0 vs 2; p=0.14) were similar for h-HIFU vs h-CRYO, respectively. Continence was maintained in 100% h-HIFU vs 98% h-CRYO, p=1.00. CONCLUSIONS: Hemi-gland HIFU or CRYO for intermediate risk PCa provide acceptable short-medium term oncologic outcomes with excellent function outcomes. Hemi-gland CRYO provided longer radical treatment-free survival than hemi-gland HIFU. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e940 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masatomo Kaneko More articles by this author Alireza Ghoreifi More articles by this author Samuel Peretsman More articles by this author Dordaneh Sugano More articles by this author Giovanni Cacciamani More articles by this author Amir Lebastchi More articles by this author Suzanne Palmer More articles by this author Manju Aron More articles by this author Osamu Ukimura More articles by this author Inderbir Gill More articles by this author Andre Abreu More articles by this author Expand All Advertisement PDF DownloadLoading ...