Mp25-18 Predictors of Treatment Failure After Focal High-Intensity Focused Ultrasound (Hifu) of Localized Prostate Cancer

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-18 PREDICTORS OF TREATMENT FAILURE AFTER FOCAL HIGH-INTENSITY FOCUSED ULTRASOUND (HIFU) OF LOCALIZED PROSTATE CANCER Simon John Christoph Soerensen, Elijah R. Sommer, Steve R. Zhou, Mirabela Rusu, Richard E. Fan, and Geoffrey A. Sonn Simon John Christoph SoerensenSimon John Christoph Soerensen , Elijah R. SommerElijah R. Sommer , Steve R. ZhouSteve R. Zhou , Mirabela RusuMirabela Rusu , Richard E. FanRichard E. Fan , and Geoffrey A. SonnGeoffrey A. Sonn View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal High-Intensity Focused Ultrasound (HIFU) for prostate cancer treatment provides acceptable local disease control while keeping morbidity low, yet recurrences are common. We sought to identify pre-treatment factors that predict persistent cancer at 1 year. METHODS: 144 patients underwent focal HIFU for localized prostate cancer at a single institution from 2016-2022. We excluded patients if they had undergone prior radiation, ADT or HIFU treatment (N=15) or if biopsy results at 1 year were unavailable (N=52), resulting in a cohort of 77 patients. Treatment failure was defined as ISUP Grade Group≥2 on 12-month biopsy, which consisted in repeat MRI, targeted biopsy of suspicious PIRADS v2.1≥3 lesions, and systematic biopsy. We conducted univariate logistic regression analysis of pre-treatment factors that may be associated with treatment failure. RESULTS: At 1-year biopsy, 18% of treated subjects had ISUP Grade Group≥2 cancer. We identified 16 covariates for analysis (Table 1). Lesion location was the only factor associated with treatment failure; involvement of the base conferred an increased risk for failure (OR=3.55, p=0.046, AUC=0.63), whereas involvement of the mid-gland was protective (OR=0.22, p=0.016, AUC=0.68). Peripheral zone lesions were less likely to result in failure than central gland lesions (OR=0.22, p=0.042, AUC=0.60, Table 2). CONCLUSIONS: Involvement of the prostate base was associated with a threefold increase in the odds of treatment failure following focal HIFU for localized prostate cancer. Conversely, the involvement of the mid-gland and/or peripheral zone were associated with significantly decreased odds of treatment failure. Urologists should consider lesion location when selecting patients for focal HIFU. Source of Funding: Stanford University (Departments of Radiology and Urology) and by the generous philanthropic support of donors to the Urologic Cancer Innovation Laboratory at Stanford University © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e411 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Simon John Christoph Soerensen More articles by this author Elijah R. Sommer More articles by this author Steve R. Zhou More articles by this author Mirabela Rusu More articles by this author Richard E. Fan More articles by this author Geoffrey A. Sonn More articles by this author Expand All Advertisement PDF downloadLoading ...