title: Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer: a multicenter study.
abstract: We report a multicenter trial with transrectal high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. A total of 72 consecutive patients with stage T1c-2NOM0 prostate cancer were treated using the Sonablate 500TM HIFU device (Focus Surgery, Indianapolis, USA). Biochemical recurrence was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The median age and prostate specific antigen (PSA) level were 72 years and 8.10 ng/ml, respectively. The median follow-up period for all patients was 14.0 months. Biochemical disease-free survival rates in all patients at 1 and 2 years were 78% and 76%, respectively. Biochemical disease-free survival rates in patients with stage T1c, T2a and T2b groups at 2 years were 89, 67% and 40% (p = 0.0817). Biochemical disease-free survival rates in patients with Gleason scores of 2-4, 5-7 and 8-10 at 2 years were 88, 72% and 80% (p = 0.6539). Biochemical disease-free survival rates in patients with serum PSA of less than 10 ng/ml and 10-20 ng/ml were 75% and 78% (p = 0.6152). No viable tumor cells were noted in 68% of patients by postoperative prostate needle biopsy. Prostatic volume was decreased from 24.2 ml to 14.0 ml at 6 months after HIFU (p < 0.01). No statistically significant differences were noted in International Prostate Symptom Score, maximum urinary flow rate and quality of life analysis with Functional Assessment of Cancer Therapy. HIFU therapy appears to be minimally invasive, efficacious and safe for patients with localized prostate cancer with pretreatment PSA levels less than 20 ng/ml.
authors.affiliation: The Department of Urology, Tokai University Hachioji Hospital.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Uchida
authors.forename: Shiro
authors.initials: S
authors.lastname: Baba
authors.forename: Akira
authors.initials: A
authors.lastname: Irie
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Soh
authors.forename: Naoya
authors.initials: N
authors.lastname: Masumori
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Nakatsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujimoto
authors.forename: Tadao
authors.initials: T
authors.lastname: Kakizoe
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueda
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Ohta
authors.forename: Tadaichi
authors.initials: T
authors.lastname: Kitamura
authors.forename: Makoto
authors.initials: M
authors.lastname: Sumitomo
authors.forename: Masamichi
authors.initials: M
authors.lastname: Hayakawa
authors.forename: Teiichiro
authors.initials: T
authors.lastname: Aoyagi
authors.forename: Masaaki
authors.initials: M
authors.lastname: Tachibana
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Ikeda
authors.forename: Kohji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Nobuo
authors.initials: N
authors.lastname: Tsuru
authors.forename: Kazuo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Ozono
authors.forename: Kiyohide
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Hirao
authors.forename: Kohichi
authors.initials: K
authors.lastname: Monden
authors.forename: Yasutomo
authors.initials: Y
authors.lastname: Nasu
authors.forename: Hiromi
authors.initials: H
authors.lastname: Kumon
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nishi
authors.forename: Shoichi
authors.initials: S
authors.lastname: Ueda
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Koga
authors.forename: Seiji
authors.initials: S
authors.lastname: Naitoh
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D036761:Ultrasound, High-Intensity Focused, Transrectal
chemical_list: D017430:Prostate-Specific Antigen