Mp25-14 Mri-Guided Transurethral Ultrasound Ablation of Localized Prostate Cancer: Single Institution Experience of Treatment Efficacy

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-14 MRI-GUIDED TRANSURETHRAL ULTRASOUND ABLATION OF LOCALIZED PROSTATE CANCER: SINGLE INSTITUTION EXPERIENCE OF TREATMENT EFFICACY Emily Bochner, Jonathan Balcazar, Debora Z. Recchimuzzi, Samuel Gold, Alberto Diaz de Leon, Kenneth Goldberg, Yair Lotan, and Xiaosong Meng Emily BochnerEmily Bochner , Jonathan BalcazarJonathan Balcazar , Debora Z. RecchimuzziDebora Z. Recchimuzzi , Samuel GoldSamuel Gold , Alberto Diaz de LeonAlberto Diaz de Leon , Kenneth GoldbergKenneth Goldberg , Yair LotanYair Lotan , and Xiaosong MengXiaosong Meng View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (TULSA) has emerged as a new option for treatment of localized prostate cancer (PCa). Here we report on our institutional experience with the TULSA procedure regarding initial disease status and follow-up imaging and pathology from our cohort. METHODS: This is a single-center study of prospectively collected data of men with localized PCa who underwent TULSA as primary treatment. All men were evaluated with prostate MRI and prostate biopsy prior to treatment. Treatment plans were individualized based on disease characteristics and patient preference. Patients were followed at routine intervals with PSA every 3 months and repeat prostate MRI and biopsy at 1 year. Primary treatment efficacy was defined as the number of men after 1-year imaging/biopsy follow-up who underwent salvage treatment. Wilcoxon signed-rank test was used for comparative statistics. RESULTS: From October 2020 - June 2023, 126 patients underwent TULSA as primary treatment for PCa. Patient characteristics are listed in Table 1. At 1-year post-TULSA, PSA decreased by 72.1% (IQR 56.3-92.1%), p<0.0001. 63/126 (50.0%) patients have undergone follow-up MRI. Prostate volume decreased by 51.4.% (IQR 26.2-68.9%) and median PSA density decreased by 49.9% (IQR 14.1-86.6%). On 1-year MRI, 18/63 (28.6%) patients had focal lesions. 23/63 (36.5%) patients refused 1-year biopsy after negative 1-year MRI. 40/63 (63.5%) patients underwent repeat systematic plus targeted (when applicable) biopsy at 1 year with 14 PCa recurrences: 1 GG3, 6 GG2, 4 GG1, and 3 ungraded due to treatment effect. 4/63 (6.3%) men with 1-year follow-up have undergone salvage treatment (2 repeat TULSA, 1 surgery, 1 radiation). CONCLUSIONS: Our experience with TULSA demonstrates substantial post-procedure decreases in PSA, PSA density and prostate volume. While 35% (14/40) of men had PCa on 1 year follow-up biopsy, only 28% (4/14) underwent additional treatment, with the remaining 10 men electing for active surveillance. Including men with negative MRIs who refused follow-up biopsy, 6% of men reaching the 1-year post-TULSA endpoint have undergone salvage treatment, demonstrating promising primary treatment efficacy at this early timepoint in our TULSA experience. Source of Funding: Dedman Family Scholar in Clinical Care, Simmons Comprehensive Cancer Center (SCCC) Early-Stage Clinical Investigator Award © 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 Emily Bochner More articles by this author Jonathan Balcazar More articles by this author Debora Z. Recchimuzzi More articles by this author Samuel Gold More articles by this author Alberto Diaz de Leon More articles by this author Kenneth Goldberg More articles by this author Yair Lotan More articles by this author Xiaosong Meng More articles by this author Expand All Advertisement PDF downloadLoading ...