Partial Gland Treatment of Prostate Cancer Using High-Intensity Focused Ultrasound in the Primary and Salvage Settings

A Systematic Review

Ron Golan, Adrien N. Bernstein, Timothy D. McClure, Art Sedrakyan, Neal A. Patel, Dipen J Parekh, Leonard S. Marks, Jim C. Hu

Research output: Contribution to journalReview article

15 Citations (Scopus)

Abstract

Purpose Advances in prostate imaging, biopsy and ablative technologies have been accompanied by growing enthusiasm for partial gland ablation, particularly using high-intensity focused ultrasound, to treat prostate cancer. Preserving noncancerous prostate tissue and minimizing damage to the neurovascular bundles and external urethral sphincter may improve functional outcomes. Materials and Methods A systematic review was performed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using a combination of MeSH® terms, free text search and examination of relevant bibliographies using MEDLINE® and Embase® from the inception of each database through October 10, 2016. We excluded studies describing exclusively whole gland ablation, case reports and series where treatment was followed by immediate resection. Results A total of 13 studies that enrolled 543 patients were included. Of the studies 11 were performed in the primary setting and 2 in the salvage setting. Median followup ranged from 6 months to 10.6 years. Rates of posttreatment erectile dysfunction and urinary incontinence ranged from 0% to 48% and 0% to 50%, respectively, with definitions varying by study. Overall there were 254 reported complications. Marked heterogeneity between studies limited the ability to pool results regarding functional and oncologic outcomes. A total of 76 patients (14%) subsequently received further oncologic treatment. Conclusions Early evidence suggests that partial gland ablation is a safe treatment option for men with localized disease. Longer term data are needed to evaluate oncologic efficacy and functional outcomes, and will aid in identifying the optimal candidates for therapy. Standardization of outcomes definitions will allow for better comparison between studies and among treatment modalities.

Original languageEnglish (US)
Pages (from-to)1000-1009
Number of pages10
JournalJournal of Urology
Volume198
Issue number5
DOIs
StatePublished - Nov 1 2017

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Prostatic Neoplasms
Prostate
Therapeutics
Aptitude
Urinary Incontinence
Bibliography
Erectile Dysfunction
Urethra
MEDLINE
Meta-Analysis
Databases
Guidelines
Technology
Biopsy

Keywords

  • ablation techniques
  • high-intensity focused ultrasound ablation
  • prostatic neoplasms

ASJC Scopus subject areas

  • Urology

Cite this

Partial Gland Treatment of Prostate Cancer Using High-Intensity Focused Ultrasound in the Primary and Salvage Settings : A Systematic Review. / Golan, Ron; Bernstein, Adrien N.; McClure, Timothy D.; Sedrakyan, Art; Patel, Neal A.; Parekh, Dipen J; Marks, Leonard S.; Hu, Jim C.

In: Journal of Urology, Vol. 198, No. 5, 01.11.2017, p. 1000-1009.

Research output: Contribution to journalReview article

Golan, Ron ; Bernstein, Adrien N. ; McClure, Timothy D. ; Sedrakyan, Art ; Patel, Neal A. ; Parekh, Dipen J ; Marks, Leonard S. ; Hu, Jim C. / Partial Gland Treatment of Prostate Cancer Using High-Intensity Focused Ultrasound in the Primary and Salvage Settings : A Systematic Review. In: Journal of Urology. 2017 ; Vol. 198, No. 5. pp. 1000-1009.
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