Follow-up includes MRI with subsequent 12-core random biopsies and targeted biopsies to any suspicious lesion at MRI 6–12 months after treatment. PSA kinetics is based on 6 months PSA tests. In case of a suspicious PSA rise (> 0.5ng/ml/yr) a biopsy is performed. Functional Results of the AFU study (HIFU hemi-ablation) (Figure 1) in 111 patients at 2 years of follow-up showed grade 3 adverse events in 13%4. At 12 months continence and erectile functions were preserved in 97% and 78% of patients. No significant decrease in quality of life score was observed at 12 months follow-up. FT failure may be reported in one of the following definitions5: 1-ablation failure : treatment failure due to the ablative energy inadequately destroying treated tissue, 2- targeting failure : the energy is not adequately applied to the tumor spatially, 3- selection failure occurs when a patient was wrongfully selected for FT.
Ablative techniques demonstrate acceptable short-term oncologic outcomes but will require longer follow-up to determine their true oncologic efficacy. To date, there are no randomized controlled trials comparing FT to conventional radical prostatectomy or radiotherapy, and there is limited oncologic follow-up beyond 5 years. There is a real need for long-term results from several centers.
Speaker: Arnauld Villers, MD, PhD Department of Urology Lille University, France
Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre @GoldbergHanan at The 15th Meeting of the EAU Section of Oncological Urology ESOU18 - January 26-28, 2018 - Amsterdam, The Netherlands
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