Mp25-13 Holmium Laser Enucleation and High-Intensity Focused Ultrasound for Large Prostates With Localized Cancer: A Single-Institution Pilot Study on Oncological and Functional Results

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-13 HOLMIUM LASER ENUCLEATION AND HIGH-INTENSITY FOCUSED ULTRASOUND FOR LARGE PROSTATES WITH LOCALIZED CANCER: A SINGLE-INSTITUTION PILOT STUDY ON ONCOLOGICAL AND FUNCTIONAL RESULTS Tarek Ajami, Ruben Blachman-Braun, Joao Porto, Sunwoo Han, Sanoj Punnen, Mark L. Gonzalgo, Chad Ritch, Dipen J. Parekh, Hemendrah Shah, and Bruno Nahar Tarek AjamiTarek Ajami , Ruben Blachman-BraunRuben Blachman-Braun , Joao PortoJoao Porto , Sunwoo HanSunwoo Han , Sanoj PunnenSanoj Punnen , Mark L. GonzalgoMark L. Gonzalgo , Chad RitchChad Ritch , Dipen J. ParekhDipen J. Parekh , Hemendrah ShahHemendrah Shah , and Bruno NaharBruno Nahar View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: High-Intensity Focused Ultrasound (HIFU) is a promising treatment for localized prostate cancer (PCa). However, this technique faces challenges when treating large prostates. Given the established role of Holmium Laser Enucleation of the Prostate (HoLEP) as a size independent procedure for surgical treatment of benign prostatic hyperplasia (BPH), we investigated efficacy and safety of combined HIFU and HoLEP in treating patients with both localized Pca and prostate >60 gm. METHODS: All patients who underwent HIFU for treatment of localized Pca were prospectively enrolled in our study. We reviewed records of patients undergoing the procedure from January 2016 to January 2023. Patients with prostate size >60 gm were offered combined HoLEP as a debulking procedure to avoid worsening of BPH-related symptoms post-HIFU. Oncological outcomes (PSA kinetics, recurrence rates, treatment failure) and functional results (SHIM, IPSS, urinary complications) were compared between patients undergoing combined HoLEP and HIFU with those underwent HIFU-monotherapy. RESULTS: Among 100 patients, 74 underwent HIFU-monotherapy and 26 underwent the combined HoLEP and HIFU. The majority had intermediate-risk PCa (67%). Pathologic assessment of HoLEP specimens showed no tumor evidence in 57% of cases. In comparison to the HIFU-only group, the HoLEP and HIFU group exhibited significantly lower PSA metrics across various intervals, however, no differences were found regarding overall and infield recurrences and treatment failure rates. While the combined treatment initially resulted in higher incontinence rates and shorter catheterization durations (p60 cc prostate volume without compromising early oncological outcomes there by expanding therapeutic scope of HIFU in treating patients with localized PCa and large adenomas. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e409 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Tarek Ajami More articles by this author Ruben Blachman-Braun More articles by this author Joao Porto More articles by this author Sunwoo Han More articles by this author Sanoj Punnen More articles by this author Mark L. Gonzalgo More articles by this author Chad Ritch More articles by this author Dipen J. Parekh More articles by this author Hemendrah Shah More articles by this author Bruno Nahar More articles by this author Expand All Advertisement PDF downloadLoading ...