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Role of Systematic Control Biopsies following Partial Gland Ablation with High-Intensity Focused Ultrasound for Clinically Significant Prostate Cancer.
- Source :
-
The Journal of urology [J Urol] 2021 Nov; Vol. 206 (5), pp. 1177-1183. Date of Electronic Publication: 2021 Jul 12. - Publication Year :
- 2021
-
Abstract
- Purpose: Partial gland ablation (PGA) using high-intensity focused ultrasound (HIFU) is currently under investigation for clinically significant prostate cancer (Cs-PCa). Our primary objective was to assess the role of systematic control biopsies following HIFU-PGA in a cohort of Cs-PCa patients.<br />Materials and Methods: We studied a single-center retrospective cohort of 77 men treated with HIFU-PGA between October 2015 and December 2019. Patients with unilateral Cs-PCa, defined as Gleason grade group (GGG) ≥2, with visible lesion on multiparametric magnetic resonance imaging (mpMRI) and prostate specific antigen (PSA) ≤15 ng/ml were included. All patients underwent mpMRI with systematic and targeted biopsies before and after HIFU-PGA. The primary outcome was the rate of Cs-PCa at control biopsy within 1 year of treatment. Logistic regression was performed to identify predictive factors of our primary outcome.<br />Results: Median age was 67 years (IQR 61-71), median PSA was 7 ng/ml (IQR 5.5-8.9). Pre-treatment biopsies revealed 48 (62.3%) GGG2 lesions, 24 (31.2%) GGG3 and 5 (6.5%) GGG4 lesions. Cs-PCa was found in 24 (31.2%) patients at systematic control biopsy post-HIFU; Cs-PCa was in the treated lobe for 18 (27%) patients. No variables were identified as significant predictors of Cs-PCa at control biopsy, including PSA kinetics and control mpMRI. Median followup time was 17 months (95% CI 15-21). Median time to any retreatment was 32 months (95% CI 23-42).<br />Conclusions: Systematic control biopsy within a year after PGA for Cs-PCa can identify the presence of residual Cs-PCa in up to a third of patients. From our early experience, control biopsy should be systematically offered patients regardless of PSA kinetics or control mpMRI results.
- Subjects :
- Aged
Biopsy, Large-Core Needle statistics & numerical data
Feasibility Studies
Follow-Up Studies
Humans
Kallikreins blood
Male
Middle Aged
Multiparametric Magnetic Resonance Imaging
Neoplasm Grading
Neoplasm, Residual
Prostate diagnostic imaging
Prostate-Specific Antigen blood
Prostatic Neoplasms blood
Prostatic Neoplasms pathology
Prostatic Neoplasms therapy
Retreatment statistics & numerical data
Retrospective Studies
Ultrasonography, Interventional
High-Intensity Focused Ultrasound Ablation statistics & numerical data
Prostate pathology
Prostatic Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1527-3792
- Volume :
- 206
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The Journal of urology
- Publication Type :
- Academic Journal
- Accession number :
- 34251879
- Full Text :
- https://doi.org/10.1097/JU.0000000000001934