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Sandy Srinivas, MD


First-Hand Experience With Focal Therapy for Localized Prostate Cancer

By: Julia Fiederlein Cipriano, MS
Posted: Thursday, October 12, 2023

Transurethral ultrasound ablation appeared to be effective in the treatment of patients with localized prostate cancer, according to Susanne Hellms, MD, of Hannover Medical School, Germany, and colleagues. The results of this single-center study, which were published in the journal BMC Urology, also revealed no major adverse events or complications during the postoperative period.

“Nevertheless, we could observe a decrease of erectile function in our small cohort,” the investigators added. “The risk of erectile function impairment requires elaborate information of the patient.”

The investigators focused on 22 patients (mean age, 67 ± 7 years; mean prostate-specific antigen [PSA] level, 6.8 ± 2.1 ng/mL) who collectively underwent 6 whole-gland and 16 focal transurethral ultrasound ablations between October 2019 and June 2021. A total of 6 and 14 tumors were classified as International Society of Urological Pathology (ISUP) grades I and II, respectively. Disease recurrence was documented in two patients after prior radiotherapy.

Expanded Prostate Cancer Index Composite (EPIC) scoring revealed no significant changes in urinary continence, irritative or obstructive voiding symptoms, bowel irritation, or hormonal symptoms during the 12-month follow-up period. Erectile function was found to be significantly impaired 3 to 6 months (P < .01) and 9 to 12 months (P < .05) after transurethral ultrasound ablation.

Transurethral ultrasound ablation seemed to result in a significant decrease in PSA values compared with those recorded prior to the procedure (P < .001). Intraprostatic residual or recurrent disease was diagnosed in 23% of patients within the first 6 to 12 months after transurethral ultrasound ablation.

Disclosure: The study authors reported no conflicts of interest.

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