Oderda Marco, Marquis Alessandro, Calleris Giorgio, D'Agate Daniele, Faletti Riccardo, Gatti Marco, Marra Giancarlo, Gontero Paolo
Division of Urology, Department of Surgical Sciences, Molinette Hospital, University of Turin, Turin, Italy.
Division of Radiology, Molinette Hospital, University of Turin, Turin, Italy.
Eur Urol Open Sci. 2022 Oct 22;46:3-7. doi: 10.1016/j.euros.2022.10.004. eCollection 2022 Dec.
Focal therapy has emerged as an interesting option for localized low- to intermediate-risk prostate cancer (PCa). Targeted microwave ablation (TMA) is a novel FT modality involving targeted delivery of microwave energy under multiparametric magnetic resonance imaging (MRI)/ultrasound guidance.
To describe the step-by-step procedure for TMA and report early functional outcomes.
This was an experimental phase 1-2 trial in 11 patients diagnosed with a single, MRI-visible PCa lesion of up to 12 mm, scored as International Society of Urological Pathology grade group (GG) 1 or 2.
Transperineal TMA under MRI/ultrasound image fusion guidance.
We recorded patient and PCa features; intraoperative and postoperative parameters; pain (Visual Analog Scale [VAS]) and adverse events (Common Terminology Criteria for Adverse Events v5.0); and prostate-specific antigen (PSA), International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) scores at 1 wk and 1, 3, and 6 mo.
The median patient age was 67 yr (interquartile range [IQR] 18). Median PSA was 5.4 ng/ml (IQR 1.8), median prostate volume was 51 cm (IQR 35), and median lesion size on MRI was 10 mm (IQR 4). Ten patients had GG 2 PCa and one had GG 1 disease. The median procedure time was 40 min (IQR 30). No intraoperative complications were reported. All treatments were performed on a day-case basis and no patients were discharged with a urinary catheter. Postoperatively, no grade ≥2 complications were reported. No significant changes in PSA ( = 0.46), IPSS ( = 0.39), or IIEF-5 scores ( = 0.18) scores were reported. The postoperative VAS score at 24 h was 0 for all patients.
TMA is safe, feasible, and well tolerated in patients with low- to intermediate-risk PCa. Oncological outcomes are still awaited.
Targeted microwave therapy is safe and feasible for selected patients with low- to intermediate-risk prostate cancer. The procedure is well tolerated and does not require a urinary catheter after the procedure. Cancer control outcomes are still awaited.
聚焦治疗已成为局限性低至中危前列腺癌（PCa）的一种有趣选择。靶向微波消融（TMA）是一种新型聚焦治疗方式，涉及在多参数磁共振成像（MRI）/超声引导下靶向输送微波能量。
描述TMA的逐步操作过程并报告早期功能结果。
设计、设置和参与者：这是一项针对11例患者的1-2期实验性试验，这些患者被诊断出有单个MRI可见的PCa病灶，最大直径达12mm，病理分级为国际泌尿病理学会分级组（GG）1级或2级。
在MRI/超声图像融合引导下经会阴进行TMA。
我们记录了患者和PCa的特征；术中及术后参数；疼痛（视觉模拟评分法[VAS]）和不良事件（不良事件通用术语标准第5.0版）；以及1周、1个月、3个月和6个月时的前列腺特异性抗原（PSA）、国际前列腺症状评分（IPSS）和国际勃起功能指数（IIEF-5）评分。
患者中位年龄为67岁（四分位间距[IQR]为18）。PSA中位数为5.4ng/ml（IQR为1.8），前列腺体积中位数为51cm³（IQR为35），MRI上病灶大小中位数为10mm（IQR为4）。10例患者为GG2级PCa，1例为GG1级疾病。中位手术时间为40分钟（IQR为30）。未报告术中并发症。所有治疗均在日间手术基础上进行，且没有患者留置导尿管出院。术后，未报告≥2级并发症。PSA（P=0.46）、IPSS（P=0.39）或IIEF-5评分（P=0.18）均无显著变化。所有患者术后24小时的VAS评分为0。
TMA在低至中危PCa患者中是安全、可行且耐受性良好的。肿瘤学结果仍有待观察。
靶向微波治疗对选定的低至中危前列腺癌患者是安全可行的。该手术耐受性良好，术后无需留置导尿管。癌症控制结果仍有待观察。
