The Role of Percentage of Prostate-specific Antigen Reduction After Focal Therapy Using High-intensity Focused Ultrasound for Primary Localised Prostate Cancer. Results from a Large Multi-institutional Series: European Urology

A. Stabile, C. Orczyk, F. Giganti, M. Moschini, C. Allen, S. Punwani, N. Cathala, H.U. Ahmed, X. Cathelineau, F. Montorsi, M. Emberton, A. Briganti, R. Sanchez-Salas, C.M. Moore

Research output: Contribution to journalArticlepeer-review

Abstract

Focal therapy (FT) for prostate cancer (PCa) is emerging as a novel therapeutic approach for patients with low- to intermediate-risk disease, in order to provide acceptable oncological control, whilst avoiding the side effects of radical treatment. Evidence regarding the ideal follow-up strategy and the significance of prostate-specific antigen (PSA) kinetics after treatment is needed. In this study, we aimed to assess the value of the percentage of PSA reduction (%PSA reduction) after FT in predicting the likelihood of any additional treatment or any radical treatment. We retrospectively analysed a multicentre cohort of 703 men receiving FT for low- and intermediate-risk PCa. Overall, the rates of any additional treatment and any radical treatment were 30% and 13%, respectively. The median follow-up period was 41 mo. The median %PSA reduction after FT was 73%. At Cox multivariable analysis, %PSA reduction was an independent predictor of any additional treatment (hazard ratio [HR]: 0.96; p < 0.001) and radical treatment (HR: 0.97; p < 0.001) after FT. For %PSA reduction of>90%, the probability of any additional treatment within 5 yr was 20%. Conversely, for %PSA reduction of
Original languageEnglish
Pages (from-to)155-160
Number of pages6
JournalEur. Urol.
Volume78
Issue number2
DOIs
Publication statusPublished - 2020

Keywords

  • Focal therapy
  • High-intensity focused ultrasound
  • Minimally invasive therapy
  • Outcome
  • Prostate cancer
  • Therapy
  • prostate specific antigen
  • adult
  • aged
  • Article
  • cancer hormone therapy
  • cancer radiotherapy
  • cancer therapy
  • cohort analysis
  • external beam radiotherapy
  • focal therapy
  • follow up
  • Gleason score
  • high intensity focused ultrasound
  • human
  • intermediate risk patient
  • major clinical study
  • male
  • priority journal
  • prostate cancer
  • prostate volume
  • prostatectomy
  • retrospective study

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