Transrectal high-intensity focused ultrasound in the treatment of localized prostate cancer: a multicenter study.
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.
Uchida
Toyoaki
T
The Department of Urology, Tokai University Hachioji Hospital.
Baba
Shiro
S
Irie
Akira
A
Soh
Shigehiro
S
Masumori
Naoya
N
Tsukamoto
Taiji
T
Nakatsu
Hiroomi
H
Fujimoto
Hiroyuki
H
Kakizoe
Tadao
T
Ueda
Takeshi
T
Ichikawa
Tomohiko
T
Ohta
Nobutaka
N
Kitamura
Tadaichi
T
Sumitomo
Makoto
M
Hayakawa
Masamichi
M
Aoyagi
Teiichiro
T
Tachibana
Masaaki
M
Ikeda
Ryusuke
R
Suzuki
Kohji
K
Tsuru
Nobuo
N
Suzuki
Kazuo
K
Ozono
Seiichiro
S
Fujimoto
Kiyohide
K
Hirao
Yoshihiko
Y
Monden
Kohichi
K
Nasu
Yasutomo
Y
Kumon
Hiromi
H
Nishi
Kazuhiko
K
Ueda
Shoichi
S
Koga
Hirofumi
H
Naitoh
Seiji
S
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
D017430:Prostate-Specific Antigen