A single centre experience in treating localised prostate cancer with focal HIFU ablation over 8 years
BAUS ePoster online library. Johnston M.
Jun 26, 2018; 211343
Mr. Maximilian Johnston
Mr. Maximilian Johnston
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Abstract
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Introduction: With improving accuracy in diagnosis and identification of index prostate cancer lesions, focal ablation has become a more palatable approach for treating significant unilateral disease, this technique was adopted in our centre 8 years ago. Here we report our intermediate outcomes.

Patients and Methods: 149 men underwent partial gland HIFU. Diagnostics included PSA, MpMRI, mapping biopsies followed by focal ablation of significant cancer as defined by the UCL criteria. Follow-up MRI, PSA, QOL questionnaires, biopsy for cause, and redo HIFU if required as part of the treatment strategy per EAU International Multidisciplinary Consensus on Trial Design for Focal Therapy guidelines.

Results: Mean age of 66 years, 89% of subjects had intermediate/high risk disease, and mean pre-HIFU PSA was 7.4. 31% had high volume Gleason 6 disease, 55% had Gleason 3+4 disease, and 13% had Gleason 4+3 disease. 61% received a Hemi-ablation, 31% a focal ablation, and 8% a quadrant ablation. Mean follow-up was 40 months, subjects' PSA dropped to an average 70% nadir. 8% had BCR. 6% required salvage treatment (five men underwent radical prostatectomy, four with radiotherapy). Freedom from additional procedures for clinically significant recurrent disease, including redo-HIFU, was 83%. Post-operative complications included 0.6% new use of pads, 1.3% urethral stricture, 2.6% post-HIFU TURP, and new onset ED of 14%.

Conclusion: In a carefully chosen cohort of patients for focal HIFU our results suggests acceptable oncological control with minimal post-operative morbidity. Further studies are required to establish this technique as a less morbid alternative to radical therapy.
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