Mp25-15 Lessons Learned: Improved Selection and Treatment Outcomes for Focal Therapy for Early Adoption to Latest Experience

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-15 LESSONS LEARNED: IMPROVED SELECTION AND TREATMENT OUTCOMES FOR FOCAL THERAPY FOR EARLY ADOPTION TO LATEST EXPERIENCE Andrea Rodriguez-Serrano, David Alejandro López Vázquez, Daniele Cignoli, Estefanía Linares-Espinós, Camille Lanz, Natalie Cathala, Eric Barret, Petr Macek, Xavier Cathelineau, and Lara Rodriguez-Sánchez Andrea Rodriguez-SerranoAndrea Rodriguez-Serrano , David Alejandro López VázquezDavid Alejandro López Vázquez , Daniele CignoliDaniele Cignoli , Estefanía Linares-EspinósEstefanía Linares-Espinós , Camille LanzCamille Lanz , Natalie CathalaNatalie Cathala , Eric BarretEric Barret , Petr MacekPetr Macek , Xavier CathelineauXavier Cathelineau , and Lara Rodriguez-SánchezLara Rodriguez-Sánchez View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.15AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy (FT) is a treatment option for localized prostate cancer (PCa) in selected patients. This study aims to provide insights into trends over 14 years of experience in FT, focusing on patient selection and treatment outcomes. METHODS: A single-center retrospective analysis was conducted on 420 patients who underwent FT between 2009 and 2023. We assessed our institution's experience with FT, utilizing Joinpoint Regression Analysis (JPRA) to calculate the annual percent change (APC) for key patient selection variables such as PSA, PSA density(dPSA), ISUP risk group, multifocality, energy modalities, treatment extension, and clinically significant recurrences (CSR) (infield and outfield). RESULTS: The baseline median PSA and PSAd were 6 ng/ml(1.6-24.9) and 0.17(0.04-1.2), respectively. HIFU was indicated for 271 patients(64.5%), Cryo for 117(27.8%), and electroporation (IRE) for 32(7.6%). Of all patients, 48.6% had ISUP grade 1 PCa, and 51.4% had ISUP≥2. Analysis showed a non-significant increasing trend in median PSA (APC: 0.9, 95%CI-0.3-2.1) and multifocal lesions (APC: 6, 95%CI-3.9-17). Conversely, dPSA exhibited a declining trend (APC: 0.1, 95%CI-2.3-2.1). Significant annual trends were observed in pre-treatment ISUP: ISUP 1 patients decreased (APC: -20, 95%CI-13.6 to -6.5, p<0.01), while ISUP 2 patients increased (APC: 18.7, 95%CI9 to 29, p<0.01). For ISUP 3 and 4 patients, analysis couldn´t be established due to the limited number of cases (ISUP 3: 6, and ISUP 4: 1). Treatment extension trends displayed a non-significant annual increase in hemiablation (APC: 1.1, 95%CI-6.8-10) and a slight decline in focal ablation (APC: -1.2, 95% CI-4.6-2.4). Energy modality trends revealed a significant increase in HIFU (APC: 5.2, 95%CI0.1-11, p<0.01) and IRE (APC: 23.8, 95%CI9-41, p<0.01), while cryo decreased (APC: -16.9, 95%CI-23.4 to -9.6, p<0.01). Annual reductions in CSR were evident across all categories (total, infield and outfield) (Figure 1), although didn't reach statistical significance. CONCLUSIONS: Over 14 years, we observed a shift towards the treatment of more aggressive diseases while still maintaining favorable oncological outcomes, in terms of CSR. This can be attributed to improved patient selection and advancements in treatment techniques. Download PPT Source of Funding: There is not source of funding © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e410 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Andrea Rodriguez-Serrano More articles by this author David Alejandro López Vázquez More articles by this author Daniele Cignoli More articles by this author Estefanía Linares-Espinós More articles by this author Camille Lanz More articles by this author Natalie Cathala More articles by this author Eric Barret More articles by this author Petr Macek More articles by this author Xavier Cathelineau More articles by this author Lara Rodriguez-Sánchez More articles by this author Expand All Advertisement PDF downloadLoading ...