Magnetic resonance imaging-guided transurethral ultrasound ablation in patients with localised prostate cancer

• Verfasst von: Nair, Shiva [VerfasserIn]
• Verfasst von: Hatiboglu, Gencay [VerfasserIn]
• Verfasst von: Relle, James [VerfasserIn]
• Verfasst von: Hetou, Khalil [VerfasserIn]
• Verfasst von: Hafron, Jason [VerfasserIn]
• Verfasst von: Harle, Christopher [VerfasserIn]
• Verfasst von: Kassam, Zahra [VerfasserIn]
• Verfasst von: Staruch, Robert [VerfasserIn]
• Verfasst von: Burtnyk, Mathieu [VerfasserIn]
• Verfasst von: Bonekamp, David [VerfasserIn]
• Verfasst von: Schlemmer, Heinz-Peter [VerfasserIn]
• Verfasst von: Röthke, Matthias C. [VerfasserIn]
• Verfasst von: Wolf, Maya Barbara [VerfasserIn]
• Verfasst von: Pahernik, Sascha [VerfasserIn]
• Verfasst von: Chin, Joseph L. [VerfasserIn]
• Titel: Magnetic resonance imaging-guided transurethral ultrasound ablation in patients with localised prostate cancer
• Titelzusatz: 3-year outcomes of a prospective Phase I study
• Verf.angabe: Shiva M. Nair, Gencay Hatiboglu, James Relle, Khalil Hetou, Jason Hafron, Christopher Harle, Zahra Kassam, Robert Staruch, Mathieu Burtnyk, David Bonekamp, Heinz-Peter Schlemmer, Matthias C. Roethke, Maya Mueller-Wolf, Sascha Pahernik and Joseph L. Chin
• Jahr: 2021
• Umfang: 9 S.
• Illustrationen: Illustrationen
• Fussnoten: Online veröffentlicht: 9. Oktober 2021 ; Gesehen am 29.07.2024
• Titel Quelle: Enthalten in: BJU international
• Ort Quelle: Oxford : Wiley-Blackwell, 1999
• Jahr Quelle: 2021
• Band/Heft Quelle: 127(2021), 5, Seite 544-552
• ISSN Quelle: 1464-410X
• DOI: doi:10.1111/bju.15268
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: #PCSM
• Sach-SW: #ProstateCancer
• Sach-SW: #uroonc
• Sach-SW: image-guided intervention
• Sach-SW: magnetic resonance imaging
• Sach-SW: minimally invasive
• Sach-SW: Phase 1 clinical trial
• Sach-SW: prostate cancer
• Sach-SW: transurethral
• Sach-SW: ultrasound ablation
• K10plus-PPN: 1896849024

Abstract

Objectives To report the 3-year follow-up of a Phase I study of magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (TULSA) in 30 men with localised prostate cancer. Favourable 12-month safety and ablation precision were previously described. Patients and Methods As a mandated safety criterion, TULSA was delivered as near whole-gland ablation, applying 3-mm margins sparing 10% of peripheral prostate tissue in 30 men. After 12-month biopsy and MRI, biannual follow-up included prostate-specific antigen (PSA), adverse events (AEs), and functional quality-of-life assessment, with repeat systematic biopsy at 3 years. Results A 3-year follow-up was completed by 22 patients. Between 1 and 3 years, there were no new serious or severe AEs. Urinary and bowel function remained stable. Erectile function recovered by 1 year and was stable at 3 years. The PSA level decreased 95% to a median (interquartile range) nadir of 0.33 (0.1-0.4) ng/mL, stable to 0.8 (0.4-1.6) ng/mL at 3 years. Serial biopsies identified clinically significant disease in 10/29 men (34%) and any cancer in 17/29 (59%). By 3 years, seven men had recurrence (four histological, three biochemical) and had undergone salvage therapy without complications (including six prostatectomies). At 3 years, three of 22 men refused biopsy, and two of the 22 (9%) had clinically significant disease (one new, one persistent). Predictors of salvage therapy requirement included less extensive ablation coverage and higher PSA nadir. Conclusion With 3-year Phase I follow-up, TULSA demonstrates safe and precise ablation for men with localised prostate cancer, providing predictable PSA and biopsy outcomes, without affecting functional abilities or precluding salvage therapy.