Department of Urology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Department of Internal Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Ann Surg Oncol. 2023 Dec;30(13):8764-8769. doi: 10.1245/s10434-023-14250-4. Epub 2023 Sep 11.
We reported preliminary outcomes of high-intensity focused ultrasound (HIFU) [Sonablate] in the combination of transurethral resection of the prostate for localized prostate cancer in Taiwan.
Seventy-seven patients using Sonablate HIFU for localized prostate cancer were enrolled in this study from April 2021 to December 2022. Prostate-specific antigen biochemical recurrence, International Index of Erectile Function (IIEF)-5 scores, International Prostate Symptom Score (IPSS), quality of life (QoL) scores, and postoperative complications were recorded during follow-up.
Overall, 19.5% of patients were low-risk, 36.4% were intermediate-risk, and 44.1% were high-risk according to the D'Amico risk classification. The median follow-up was 12.09 ± 5.85 months, and the biochemical-free survival rates for the low-, intermediate-, and high-risk groups were 100% (15/15), 96.4% (27/28), and 79.4% (27/34), respectively. Four patients (5.2%) received salvage radiotherapy and all maintained biochemical-free survival. The mean IPSS and QoL scores before versus after HIFU were 10.4 versus 6.8 (p = 0.003) and 3.2 versus 3.0 (p = 0.096), respectively. There was no statistically significant change in preoperative and postoperative IIEF scores (20.6 vs. 19; p = 0.062) in patients who had an IIEF score of >15 at baseline and received nerve-sparing procedures (subtotal ablation).
The results of Sonablate HIFU in Taiwan indicated adequate short-term cancer control, excellent potency, and continence preservation. HIFU can achieve improvement of IPSS with low complication rates.
我们报道了高强度聚焦超声（HIFU）[Sonablate]联合经尿道前列腺切除术治疗台湾局限性前列腺癌的初步结果。
本研究共纳入 2021 年 4 月至 2022 年 12 月期间 77 例使用 Sonablate HIFU 治疗局限性前列腺癌的患者。在随访期间记录前列腺特异性抗原生化复发、国际勃起功能指数（IIEF）-5 评分、国际前列腺症状评分（IPSS）、生活质量（QoL）评分和术后并发症。
根据 D'Amico 风险分类，总体而言，19.5%的患者为低危，36.4%为中危，44.1%为高危。中位随访时间为 12.09±5.85 个月，低危、中危和高危组的生化无复发生存率分别为 100%（15/15）、96.4%（27/28）和 79.4%（27/34）。4 例（5.2%）患者接受挽救性放疗，均保持生化无复发生存。HIFU 治疗前后 IPSS 和 QoL 评分分别为 10.4 分和 6.8 分（p=0.003）和 3.2 分和 3.0 分（p=0.096）。术前和术后 IIEF 评分（20.6 比 19；p=0.062）在基线时 IIEF 评分>15 且接受神经保留手术（总消融）的患者中无统计学差异。
台湾 Sonablate HIFU 的结果表明，该方法具有良好的短期肿瘤控制效果、优异的勃起功能和控尿能力。HIFU 可以改善 IPSS，且并发症发生率低。
