Pd39-08 Double Tap Focal Therapy With High Intensity Focused Ultrasound Reduces Infield Recurrence

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (PD39)1 May 2024PD39-08 DOUBLE TAP FOCAL THERAPY WITH HIGH INTENSITY FOCUSED ULTRASOUND REDUCES INFIELD RECURRENCE Yamini Nagaraj, Fabian Falkenbach, Randi Marisa Pose, Jan-Lukas Hohenhorst, Jaydeep Ratkal, Raisa Pompe, Markus Graefen, and Georg Salomon Yamini NagarajYamini Nagaraj , Fabian FalkenbachFabian Falkenbach , Randi Marisa PoseRandi Marisa Pose , Jan-Lukas HohenhorstJan-Lukas Hohenhorst , Jaydeep RatkalJaydeep Ratkal , Raisa PompeRaisa Pompe , Markus GraefenMarkus Graefen , and Georg SalomonGeorg Salomon View All Author Informationhttps://doi.org/10.1097/01.JU.0001008924.16121.42.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is a wide call for higher energy levels when conducting focal therapy (FT) with high intensity focused ultrasound (HIFU) for better treatment efficiency. This can be achieved in a simple and cost-effective manner by performing a repeat treatment in the same setting, referred to as "double tap HIFU". This study aims to compare patient outcomes undergoing FT with single-tap and double tap HIFU. METHODS: We conducted a comparison between the infield recurrence (IF) of patients who underwent a single tap HIFU and those having received a double tap HIFU. Infield recurrence in control biopsies were all high volume Gleason 6, defined as ≥4 positive cores with at least 2 cores ≥3 mm tumor length and all Gleason ≥7. Urinary continence was defined as 0 pad usage and sexual potency as ≥17 in the 5-item International Index of erectile function (IIEF score). RESULTS: Of totally 160 patients 49 (30.6%) had received a single tap HIFU, of which 23 (47%) patients had a Gleason score 6 (GS 6) and 26 (53%) a GS 7a, respectively. A further 111 patients (69.4%) had a double tap HIFU with 41 (37%) and 70 (63%) having a GS of 6 and 7a, respectively. The median baseline PSA of the patients with single tap HIFU was 5.9 ng/ml and that of patients with double tap HIFU was 6 ng/ml. The median follow-up was 57.5 months (IQR 41–78.3). The median PSA level dropped to 2 ng/ml and 2.1 ng/ml in the last follow-up after single and double tap HIFU, respectively.After a single tap HIFU, 7 out of 49 patients (14.3%) experienced a significant IF recurrence, whereas in contrast, after a double tap treatment this rate were halved, reducing to 7 out of 111 patients (6.3%) respectively. Similarly, of 97 apex treatments, 3 of 32 patients (9%) showed significant infield recurrence after a single-tap HIFU, while after a double-tap apex treatment only 2 of 65 patients (3.02%) presented a significant infield recurrence.Thus, after a single tap HIFU 7 patients (14.3%) required radical treatment, whereas following a double tap HIFU, 7 patients (6.3%) needed radical therapy for IF recurrence. There were no differences in the rate of complications. After a single HIFU, the median IIEF score remained unchanged at 22, whereas double tap HIFU led to a minor decrease in erectile function, with the median IIEF score dropping from 24 to 17 in sexually potent men. Urinary continence was preserved in all patients. CONCLUSIONS: In a comparative analysis, single tap HIFU results in a significant infield recurrence rate of 14%, whereas after double tap HIFU the incidence of infield recurrence is reduced considerably to 6.3 % without raising the rate of complications. However, double tap HIFU was associated with a marginal deterioration of erectile function. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e816 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Yamini Nagaraj More articles by this author Fabian Falkenbach More articles by this author Randi Marisa Pose More articles by this author Jan-Lukas Hohenhorst More articles by this author Jaydeep Ratkal More articles by this author Raisa Pompe More articles by this author Markus Graefen More articles by this author Georg Salomon More articles by this author Expand All Advertisement PDF downloadLoading ...