Results of low threshold to biopsy following high-intensity focused ultrasound for localized prostate cancer
Context: There are different treatment options for localized prostate cancer. The success of high-intensity focused ultrasound (HIFU) is based largely on biochemical prostate specific antigen (PSA) results. Aims: To evaluate the impact of using a low PSA threshold to perform prostate biopsies after...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2012-01-01
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| Series: | Urology Annals |
| Subjects: | |
| Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2012;volume=4;issue=2;spage=84;epage=88;aulast=Haddad |
| Summary: | Context: There are different treatment options for localized prostate cancer. The success of high-intensity focused ultrasound (HIFU) is based largely on biochemical prostate specific antigen (PSA) results.
Aims: To evaluate the impact of using a low PSA threshold to perform prostate biopsies after HIFU in order to more accurately gauge treatment success.
Settings and Design: Eleven patients underwent HIFU at Sydney Adventist Hospital in Sydney, 10 as primary and 1 as salvage therapy [post external beam radiation therapy (EBRT)]. The median age was 67 years (49-77 years). This was a prospective case series.
Materials and Methods: Between 2006 and 2008, the Sonoblate device was used. Prostate biopsies were 12-core biopsies performed under local anesthesia, if PSA was ≥0.5 ng/mL or after two consecutive rises in PSA. The statistical analysis involved prospective data collection of results to calculate median and ranges.
Results: The median PSA at diagnosis was 6.7 ng/mL (5.7-10.8 ng/mL). The median follow-up was 16 months (7-26 months). Nine men (82%) had post-HIFU biopsy. The median time to post-HIFU biopsy was 11.6 months (5-20 months), and all nine men had biopsy-proven residual disease.
Conclusions: A low threshold to re-biopsy post-HIFU reveals a high local failure rate of 82%. Oncological efficacy is questioned, and using high threshold to biopsy may therefore be overestimating the effectiveness of HIFU as a primary treatment for localized prostate cancer. |
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| ISSN: | 0974-7796 0974-7834 |