A whole of population, multiuser series of high-intensity focused ultrasound for management of localized prostate cancer

Outcomes and implications

Damien Bolton, Kevin Ong, Graham Giles, Gianluca Severi, Nathan Lawrentschuk, Nathan Papa, Andrew Troy, Henry Woo, Jeremy Millar, Peter Royce

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Purpose: To determine the oncologic and complication outcomes of treatment of patients with localized prostate cancer by high intensity focused ultrasound (HIFU) for primary management of prostate cancer in a whole of population, multiuser series. Patients and Methods: We created a centralized database—accessible only by nonurologist researchers—within a cancer epidemiology center, after ethics approval from that institution. A single researcher prospectively entered baseline, treatment, and clinical/biochemical follow-up data from all patients treated with HIFU in the state of Victoria over the study period. Results: We accrued 108 patients, of whom 103 had been staged as having clinically localized disease. Ninety-three patients (86.1%) had low- or intermediate-risk prostate cancer. Forty-four patients (40.5%) had persistent mild urinary incontinence at 3 months after treatment, and 3 of these ultimately underwent further surgical procedures to correct incontinence. Twenty-seven patients (25%) additionally experienced occasions of urinary retention in the first 3 months after treatment because of passage of tissue. Twenty-nine patients had achieved a prostate-specific antigen level of <0.2 ng/mL at 3 months after HIFU. Fifty-six patients underwent post-HIFU prostate biopsy, and this was positive for residual cancer in 51 cases. Forty-five of the patients who had a positive post-HIFU biopsy underwent secondary treatment for prostate cancer. Conclusion: Oncologic control and complication outcomes in this cohort were inferior to those previously reported for HIFU in single-user series. Given the population-based multiuser nature of our series, we believe our observations are more likely to reflect the community outcomes that might be expected from widespread adoption of HIFU than generalizing from single-operator series.
Original languageEnglish
Pages (from-to)844-849
Number of pages6
JournalJournal of Endourology
Volume29
Issue number7
DOIs
Publication statusPublished - 1 Jul 2015
Externally publishedYes

Cite this

Bolton, Damien ; Ong, Kevin ; Giles, Graham ; Severi, Gianluca ; Lawrentschuk, Nathan ; Papa, Nathan ; Troy, Andrew ; Woo, Henry ; Millar, Jeremy ; Royce, Peter. / A whole of population, multiuser series of high-intensity focused ultrasound for management of localized prostate cancer : Outcomes and implications. In: Journal of Endourology. 2015 ; Vol. 29, No. 7. pp. 844-849.
@article{289ee7b2e38b49c1a482d55e02d96737,
title = "A whole of population, multiuser series of high-intensity focused ultrasound for management of localized prostate cancer: Outcomes and implications",
abstract = "Purpose: To determine the oncologic and complication outcomes of treatment of patients with localized prostate cancer by high intensity focused ultrasound (HIFU) for primary management of prostate cancer in a whole of population, multiuser series. Patients and Methods: We created a centralized database—accessible only by nonurologist researchers—within a cancer epidemiology center, after ethics approval from that institution. A single researcher prospectively entered baseline, treatment, and clinical/biochemical follow-up data from all patients treated with HIFU in the state of Victoria over the study period. Results: We accrued 108 patients, of whom 103 had been staged as having clinically localized disease. Ninety-three patients (86.1{\%}) had low- or intermediate-risk prostate cancer. Forty-four patients (40.5{\%}) had persistent mild urinary incontinence at 3 months after treatment, and 3 of these ultimately underwent further surgical procedures to correct incontinence. Twenty-seven patients (25{\%}) additionally experienced occasions of urinary retention in the first 3 months after treatment because of passage of tissue. Twenty-nine patients had achieved a prostate-specific antigen level of <0.2 ng/mL at 3 months after HIFU. Fifty-six patients underwent post-HIFU prostate biopsy, and this was positive for residual cancer in 51 cases. Forty-five of the patients who had a positive post-HIFU biopsy underwent secondary treatment for prostate cancer. Conclusion: Oncologic control and complication outcomes in this cohort were inferior to those previously reported for HIFU in single-user series. Given the population-based multiuser nature of our series, we believe our observations are more likely to reflect the community outcomes that might be expected from widespread adoption of HIFU than generalizing from single-operator series.",
author = "Damien Bolton and Kevin Ong and Graham Giles and Gianluca Severi and Nathan Lawrentschuk and Nathan Papa and Andrew Troy and Henry Woo and Jeremy Millar and Peter Royce",
note = "Export Date: 2 October 2016",
year = "2015",
month = "7",
day = "1",
doi = "10.1089/end.2014.0696",
language = "English",
volume = "29",
pages = "844--849",
journal = "Journal of Endourology",
issn = "0892-7790",
publisher = "Mary Ann Liebert Inc",
number = "7",

}

A whole of population, multiuser series of high-intensity focused ultrasound for management of localized prostate cancer : Outcomes and implications. / Bolton, Damien; Ong, Kevin; Giles, Graham; Severi, Gianluca; Lawrentschuk, Nathan; Papa, Nathan; Troy, Andrew; Woo, Henry; Millar, Jeremy; Royce, Peter.

In: Journal of Endourology, Vol. 29, No. 7, 01.07.2015, p. 844-849.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - A whole of population, multiuser series of high-intensity focused ultrasound for management of localized prostate cancer

T2 - Outcomes and implications

AU - Bolton, Damien

AU - Ong, Kevin

AU - Giles, Graham

AU - Severi, Gianluca

AU - Lawrentschuk, Nathan

AU - Papa, Nathan

AU - Troy, Andrew

AU - Woo, Henry

AU - Millar, Jeremy

AU - Royce, Peter

N1 - Export Date: 2 October 2016

PY - 2015/7/1

Y1 - 2015/7/1

N2 - Purpose: To determine the oncologic and complication outcomes of treatment of patients with localized prostate cancer by high intensity focused ultrasound (HIFU) for primary management of prostate cancer in a whole of population, multiuser series. Patients and Methods: We created a centralized database—accessible only by nonurologist researchers—within a cancer epidemiology center, after ethics approval from that institution. A single researcher prospectively entered baseline, treatment, and clinical/biochemical follow-up data from all patients treated with HIFU in the state of Victoria over the study period. Results: We accrued 108 patients, of whom 103 had been staged as having clinically localized disease. Ninety-three patients (86.1%) had low- or intermediate-risk prostate cancer. Forty-four patients (40.5%) had persistent mild urinary incontinence at 3 months after treatment, and 3 of these ultimately underwent further surgical procedures to correct incontinence. Twenty-seven patients (25%) additionally experienced occasions of urinary retention in the first 3 months after treatment because of passage of tissue. Twenty-nine patients had achieved a prostate-specific antigen level of <0.2 ng/mL at 3 months after HIFU. Fifty-six patients underwent post-HIFU prostate biopsy, and this was positive for residual cancer in 51 cases. Forty-five of the patients who had a positive post-HIFU biopsy underwent secondary treatment for prostate cancer. Conclusion: Oncologic control and complication outcomes in this cohort were inferior to those previously reported for HIFU in single-user series. Given the population-based multiuser nature of our series, we believe our observations are more likely to reflect the community outcomes that might be expected from widespread adoption of HIFU than generalizing from single-operator series.

AB - Purpose: To determine the oncologic and complication outcomes of treatment of patients with localized prostate cancer by high intensity focused ultrasound (HIFU) for primary management of prostate cancer in a whole of population, multiuser series. Patients and Methods: We created a centralized database—accessible only by nonurologist researchers—within a cancer epidemiology center, after ethics approval from that institution. A single researcher prospectively entered baseline, treatment, and clinical/biochemical follow-up data from all patients treated with HIFU in the state of Victoria over the study period. Results: We accrued 108 patients, of whom 103 had been staged as having clinically localized disease. Ninety-three patients (86.1%) had low- or intermediate-risk prostate cancer. Forty-four patients (40.5%) had persistent mild urinary incontinence at 3 months after treatment, and 3 of these ultimately underwent further surgical procedures to correct incontinence. Twenty-seven patients (25%) additionally experienced occasions of urinary retention in the first 3 months after treatment because of passage of tissue. Twenty-nine patients had achieved a prostate-specific antigen level of <0.2 ng/mL at 3 months after HIFU. Fifty-six patients underwent post-HIFU prostate biopsy, and this was positive for residual cancer in 51 cases. Forty-five of the patients who had a positive post-HIFU biopsy underwent secondary treatment for prostate cancer. Conclusion: Oncologic control and complication outcomes in this cohort were inferior to those previously reported for HIFU in single-user series. Given the population-based multiuser nature of our series, we believe our observations are more likely to reflect the community outcomes that might be expected from widespread adoption of HIFU than generalizing from single-operator series.

U2 - 10.1089/end.2014.0696

DO - 10.1089/end.2014.0696

M3 - Article

VL - 29

SP - 844

EP - 849

JO - Journal of Endourology

JF - Journal of Endourology

SN - 0892-7790

IS - 7

ER -