Focal high-intensity focused ultrasound therapy for localized prostate cancer: An interim analysis of the multinational FASST study.

Autor: Ladjevardi S; Department of Urology, University of Uppsala, Uppsala, Sweden., Ebner A; Department of Urology, Cantonal Hospital Baden, Baden, Switzerland.; Department of Urology, University Hospital Zurich, Zurich, Switzerland., Femic A; Department of Urology, University of Uppsala, Uppsala, Sweden., Huebner NA; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.; Working Group for Diagnostic imaging in Urology (ABDU), Austrian association of Urology (ÖGU), Vienna, Austria.; Department of urology, University of California Davis, Sacramento, California, USA., Shariat SF; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.; Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.; Division of Urology, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, Jordan.; Department of Urology, Weill Cornell Medical College, New York, New York, USA.; Department of Urology, University of Texas Southwestern, Dallas, Texas, USA., Kraler S; Center for Molecular Cardiology, University of Zurich, Schlieren, Switzerland.; Department of Internal Medicine, Cantonal Hospital Baden, Baden, Switzerland., Kubik-Huch RA; Department of Radiology, Cantonal Hospital Baden, Baden, Switzerland., Ahlman RC; Department of Urology, University of Uppsala, Uppsala, Sweden., Häggman M; Department of Urology, University of Uppsala, Uppsala, Sweden., Hefermehl LJ; Department of Urology, Cantonal Hospital Baden, Baden, Switzerland.
Jazyk: angličtina
Zdroj: European journal of clinical investigation [Eur J Clin Invest] 2024 Jun; Vol. 54 (6), pp. e14192. Date of Electronic Publication: 2024 Mar 06.
DOI: 10.1111/eci.14192
Abstrakt: Background: High-intensity focused ultrasound (HIFU) emerged as a novel approach for the treatment of localized prostate cancer (PCa). However, prospective studies on HIFU-related outcomes and predictors of treatment failure (TF) remain scarce.
Materials and Methods: We conducted a multinational prospective cohort study among patients undergoing HIFU therapy for localized, low- to intermediate-risk PCa. Follow-up data on serial prostate specific antigen (PSA), multi-parametric magnetic resonance imaging (mpMRI), targeted/systematic biopsies, adverse events and functional outcomes were collected. The primary endpoint was TF, defined as histologically confirmed PCa requiring whole-gland salvage treatment. Uni- and multi-variable adjusted hazard ratios (HRs) were calculated using Cox proportional hazard regression models.
Results: At baseline, mean (standard deviation) age was 64.14 (7.19) years, with the majority of patients showing T-stage 1 (73.9%) and International Society of Urological Pathology grading system Grade 2 (58.8%). PSA nadir (median, 1.70 ng/mL) was reached after 6 months. Of all patients recruited, 16% had clinically significant PCa, as confirmed by biopsy, of which 13.4% had TF. Notably, T-stage and number of positive cores at initial biopsy were independent predictors of TF during follow-up (HR [95% CI] 1.27 [1.02-1.59] and 5.02 [1.80-14.03], respectively). Adverse events were minimal (17% and 8% early and late adverse events, respectively), with stable or improved functional outcomes in the majority of patients.
Conclusions: This interim analysis of a multinational study on HIFU therapy for the management of low-to-intermediate-risk PCa reveals good functional outcomes, minimal adverse events and low incidence of TF over the short-term. Data on long-term outcomes, specifically as it relates to oncological outcomes, are awaited eagerly.
(© 2024 The Authors. European Journal of Clinical Investigation published by John Wiley & Sons Ltd on behalf of Stichting European Society for Clinical Investigation Journal Foundation.)
Databáze: MEDLINE
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