MP73-09 A RETROSPECTIVE CLINICAL SERVICE EVALUATION OF LESION-TARGETED MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION (TULSA) FOR THE TREATMENT OF LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP73-09 A RETROSPECTIVE CLINICAL SERVICE EVALUATION OF LESION-TARGETED MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION (TULSA) FOR THE TREATMENT OF LOCALIZED PROSTATE CANCER Rolf Muschter, Leonhard Steinmeister, and Agron Lumiani Rolf MuschterRolf Muschter More articles by this author , Leonhard SteinmeisterLeonhard Steinmeister More articles by this author , and Agron LumianiAgron Lumiani More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: MR-guided transurethral ultrasound ablation (TULSA) is a novel minimally-invasive therapy option for the treatment of organ-confined prostate cancer (PCa) through a whole-gland or lesion-targeted approach. TULSA has shown promising safety and oncological outcomes with minimum side-effect on patients urinary, bowel, and sexual functions. The objective of this retrospective single-center study was to perform a clinical service evaluation of lesion-targeted TULSA for patients with localized PCa. METHODS: Men with organ-confined PCa (proved by MRI and biopsy) received lesion-targeted TULSA with sparing of sphincter, urethra, and rectum. A customized treatment was planned for every patient based on his expectations and PCa characteristics. For a subset of men with concurrent PCa and benign prostate hyperplasia (BPH), TULSA was applied as a combined therapy. Repeat TULSA was allowed and a suprapubic catheter was used. The Clavien-Dindo stratification was used to assess the frequency and severity of all adverse events (AEs). Mid-term oncological outcomes were evaluated using multi-parametric MRI (mpMRI) and prostate-specific antigen (PSA). Surgeon-assessed functional outcomes were recorded. RESULTS: 180 patients (150 primary and 30 salvage) with median [IQR] age, baseline PSA, and follow-up availability of 67 [63-76], 8.0 ng/ml [5.2-13], and 12-mon (max 48), respectively, were treated. 40 patients experienced Grade 1 and 2 AEs, resolving within 4 weeks using antibiotics or relevant medication. Grade 3 AEs (urinary retention requiring surgical intervention) occurred in two patients, resolving within 3 months. No grade 4 or higher events and no bowel-related complications occurred. 98% of men preserved pad-free continence. 94/94 men, who were previously potent, maintained erectile potency. 85% of men with concurrent BPH and PCa experienced symptom relief. The mid-term oncological success rate was 88%. A single repeat TULSA was performed on 13 patients. CONCLUSIONS: Lesion-targeted TULSA is a safe and customizable prostate ablation therapy with promising mid-term oncological outcomes and minimal side-effect profile on patients erectile, bowel, and urinary functions. TULSA offers the flexibility to treat localized prostate cancer in a primary, salvage, or concurrent setting of BPH through a patient-tailored whole-gland or lesion-targeted approach. Source of Funding: No funding was received © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1038 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rolf Muschter More articles by this author Leonhard Steinmeister More articles by this author Agron Lumiani More articles by this author Expand All Advertisement PDF downloadLoading ...