Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study
Background: We compared the clinical outcomes of robot-assisted radical prostatectomy (RARP) and partial gland ablation (PGA) using high-intensity focused ultrasound (HIFU) in localized prostate cancer. Methods: We analyzed 3,859 patients who had undergone RARP and PGA using HIFU. According to the p...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-09-01
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| Series: | Prostate International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888222000770 |
| _version_ | 1797682822263078912 |
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| author | Gyoohwan Jung Jung Kwon Kim Jong Jin Oh Sangchul Lee Seok-Soo Byun Sung Kyu Hong Hakmin Lee |
| author_facet | Gyoohwan Jung Jung Kwon Kim Jong Jin Oh Sangchul Lee Seok-Soo Byun Sung Kyu Hong Hakmin Lee |
| author_sort | Gyoohwan Jung |
| collection | DOAJ |
| description | Background: We compared the clinical outcomes of robot-assisted radical prostatectomy (RARP) and partial gland ablation (PGA) using high-intensity focused ultrasound (HIFU) in localized prostate cancer. Methods: We analyzed 3,859 patients who had undergone RARP and PGA using HIFU. According to the propensity score for each treatment, 137 patients after PGA were matched to 3,722 patients after RARP at a 1:4 ratio using the nearest neighbor method. Results: The matched cohort comprised 685 subjects (RARP, 548; PGA, 137), with a median follow-up period of 22 months. Treatment failures were identified in 13.9% and 9.1% of patients in the PGA and RARP groups, respectively, after a median follow-up of 36 months postoperatively. Kaplan–Meier analyses revealed significantly longer failure-free (P < 0.001) and salvage-free survival (P = 0.003) in the RARP group than in the PGA group. There was no significant difference in the postoperative urinary symptom score (P = 0.748), but the postoperative erectile function score was significantly higher in the PGA group (P < 0.001). The rate of urinary incontinence (any pad) was significantly lower in the PGA group than that in the RARP group (P < 0.001). Postoperative complications were more frequent in the PGA group (P = 0.003); however, there was no significant difference in high-grade complications (≥3) (P = 0.467). Conclusion: PGA using HIFU showed statistically inferior oncological outcomes compared with RARP for failure-free survival and salvage-free survival. However, functional outcomes regarding postoperative incontinence and erectile dysfunction were more favorable in the PGA group. |
| first_indexed | 2024-03-12T00:05:24Z |
| format | Article |
| id | doaj.art-a7763fef72f04eb987707f5b998200b3 |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T00:05:24Z |
| publishDate | 2023-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-a7763fef72f04eb987707f5b998200b32023-09-17T04:56:52ZengElsevierProstate International2287-88822023-09-01113134138Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched studyGyoohwan Jung0Jung Kwon Kim1Jong Jin Oh2Sangchul Lee3Seok-Soo Byun4Sung Kyu Hong5Hakmin Lee6Department of Urology, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Urology, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Urology, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Urology, Seoul National University Bundang Hospital, Seongnam, KoreaDepartment of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Medical Device Development, Seoul National University College of Medicine, Seoul, KoreaDepartment of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Department of Urology, Seoul National University College of Medicine, Seoul, KoreaDepartment of Urology, Seoul National University Bundang Hospital, Seongnam, Korea; Corresponding author. Department of Urology, Seoul National University Bundang Hospital, 173-82, Gumi-ro, Bundang-gu, Seongnam, 13620, KoreaBackground: We compared the clinical outcomes of robot-assisted radical prostatectomy (RARP) and partial gland ablation (PGA) using high-intensity focused ultrasound (HIFU) in localized prostate cancer. Methods: We analyzed 3,859 patients who had undergone RARP and PGA using HIFU. According to the propensity score for each treatment, 137 patients after PGA were matched to 3,722 patients after RARP at a 1:4 ratio using the nearest neighbor method. Results: The matched cohort comprised 685 subjects (RARP, 548; PGA, 137), with a median follow-up period of 22 months. Treatment failures were identified in 13.9% and 9.1% of patients in the PGA and RARP groups, respectively, after a median follow-up of 36 months postoperatively. Kaplan–Meier analyses revealed significantly longer failure-free (P < 0.001) and salvage-free survival (P = 0.003) in the RARP group than in the PGA group. There was no significant difference in the postoperative urinary symptom score (P = 0.748), but the postoperative erectile function score was significantly higher in the PGA group (P < 0.001). The rate of urinary incontinence (any pad) was significantly lower in the PGA group than that in the RARP group (P < 0.001). Postoperative complications were more frequent in the PGA group (P = 0.003); however, there was no significant difference in high-grade complications (≥3) (P = 0.467). Conclusion: PGA using HIFU showed statistically inferior oncological outcomes compared with RARP for failure-free survival and salvage-free survival. However, functional outcomes regarding postoperative incontinence and erectile dysfunction were more favorable in the PGA group.http://www.sciencedirect.com/science/article/pii/S2287888222000770High-intensity focused ultrasound ablationOutcomeProstatectomyProstate cancerPropensity score |
| spellingShingle | Gyoohwan Jung Jung Kwon Kim Jong Jin Oh Sangchul Lee Seok-Soo Byun Sung Kyu Hong Hakmin Lee Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study Prostate International High-intensity focused ultrasound ablation Outcome Prostatectomy Prostate cancer Propensity score |
| title | Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study |
| title_full | Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study |
| title_fullStr | Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study |
| title_full_unstemmed | Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study |
| title_short | Partial gland ablation using high-intensity focused ultrasound versus robot-assisted radical prostatectomy: a propensity score-matched study |
| title_sort | partial gland ablation using high intensity focused ultrasound versus robot assisted radical prostatectomy a propensity score matched study |
| topic | High-intensity focused ultrasound ablation Outcome Prostatectomy Prostate cancer Propensity score |
| url | http://www.sciencedirect.com/science/article/pii/S2287888222000770 |
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