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Seven years of experience with high‐intensity focused ultrasound for prostate cancer: Advantages and limitations
Author(s) -
Sung Hyun Hwan,
Jeong Byong Chang,
Seo Seong Il,
Jeon Seong Soo,
Choi HanYong,
Lee Hyun Moo
Publication year - 2012
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.22491
Subject(s) - medicine , prostate cancer , biochemical recurrence , hazard ratio , proportional hazards model , prostate , prostate specific antigen , cancer , urology , oncology , surgery , prostatectomy , confidence interval
BACKGROUND The aim of this study was to evaluate oncologic outcomes and adverse events for patients with prostate cancer after treatment by high‐intensity focused ultrasound (HIFU). METHODS Between February 2004 and August 2010, patients with prostate cancer who underwent HIFU treatment were reviewed about oncologic outcomes and complications. Biochemical recurrence (BCR) was defined as prostate‐specific antigen (PSA) nadir plus 1.2 ng/ml. Kaplan–Meier analysis was performed to evaluate BCR‐ and disease progression‐free survival according to risk stratification. Predictors for BCR and disease progression were identified using the Cox‐proportional hazard method. RESULTS The overall BCR rate was 59.5%, and median time to BCR was 13.8 months. The 5‐year BCR‐free survival rates of the low‐, intermediate‐, and high‐risk groups were 66.3, 40.2, and 21.0% ( P = 0.001), respectively, and the 5‐year disease progression‐free survival rates were 73.5, 46.0, and 29.2%, respectively ( P = 0.008). Multivariate analysis showed that risk stratification, PSA nadir, and time to PSA nadir were significant predictors of BCR and disease progression. In the first 3 months post‐op, 11 patients (8.7%) had complications. There were no patients who required blood transfusions or who had wound problems, stroke, deep vein thrombosis, or bowel dysfunction. CONCLUSIONS HIFU treatment does not provide effective oncologic outcomes even in low risk patients with prostate cancer as well as in the intermediate or high risk groups. Therefore, patients selected to undergo HIFU treatment for prostate cancer must be very carefully chosen. On the other hand, HIFU treatment for prostate cancer had a very low rate of complications. Prostate 72:1399–1406, 2012. © 2012 Wiley Periodicals, Inc.