To compare the oncological and functional outcomes in localised prostate cancer patients who received non-whole-gland High-intensity focused ultrasound (HIFU) with patients who received whole-gland HIFU therapy.
86 patients from September 2012 to January 2017 in our center were retrospectively analysed. Oncological outcomes included histological absence of prostate cancer, biochemical disease-free survival (BDFS) as well as the absence of lesions suspected for harboring prostate cancer in mpMRI. Regarding functional outcomes, we determined International prostate symptom score (IPSS), pad-free rate, pad-free and leakage-free rates as well as International index of erectile function-5 (IIEF-5).
Out of the 86 patients, 25 patients who underwent non-whole-gland HIFU and 61 patients who underwent whole-gland HIFU were enrolled in our one-year follow-up study. There were no significant differences in histological absence of prostate cancer (p=0.655), BDFS (p=0.820), PSA nadir (p=0.453) and absence of suspicious lesions in mpMRI (p=0.633) between non-whole-gland HIFU group and whole-gland HIFU group. However, compared with the whole-gland HIFU, the non-whole-gland HIFU group had fewer IPSS at 1 month (8.64±3.63 versus 10.85±6.10), a longer time to PSA nadir (5.04±2.07 versus 3.83±1.65), less temporary urine retention rate (20.0% versus 44.3%), less complication rate especially urinary tract strictures (4% versus 26.2%), whereas pad-free rate, pad-free and leakage-free rates and IIEF scores were comparable. Conclusion：Non-whole-gland HIFU is a promising type of treatment for localized prostate cancer with satisfactory oncological results with less impairment of functional outcomes and complications compared to whole-gland HIFU, but it requires longer follow-up and larger samples of randomized control trials.
Journal of endourology. 2018 Dec 10 [Epub ahead of print]
Ye Lei, Patrick Zanker, Serdar Yildiz, Daniel Seidl, Orlando Koch, Christian Schwentner, Jens Mundhenk
Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; ., Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; ., Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; ., Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; ., Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; ., Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; ., Diakonie-Klinikum Stuttgart, 39928, Stuttgart, Baden-Württemberg, Germany ; .