First experiences using transurethral ultrasound ablation (TULSA) as a promising focal approach to treat localized prostate cancer: a monocentric study

BMC Urology

Research

Inga Peters¹  Markus Antonius Kuczyk²  Steffen Struckmann²  Marcel Gutberlet³  Frank Wacker³  Julian Glandorf³  Susanne Hellms³  Martha Dohna³  Bennet Hensen³ 

[1] Clinic for Urology, Krankenhaus Nordwest, Steinbacher Hohl 2-26, 60488, Frankfurt, Germany;Department of Urology and Urologic Oncology, Hannover Medical School, Carl- Neuberg Str. 1, 30625, Hannover, Germany;Department of Urology and Urologic Oncology, Hannover Medical School, Carl- Neuberg Str. 1, 30625, Hannover, Germany;Institute for Diagnostic and Interventional Radiology, Hannover Medical School, Carl- Neuberg Str. 1, 30625, Hannover, Germany;

关键词: Focal therapy;    Prostate cancer;    Multiparametric MRI;    Prostate-specific antigen;    Thermometry;    Transurethral ultrasound ablation;   

DOI  :  10.1186/s12894-023-01306-6

 received in 2022-12-01, accepted in 2023-08-01,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeTo share our experience using transurethral ultrasound ablation (TULSA) treatment for focal therapy of localized prostate cancer (PCa).Materials and methodsBetween 10/2019 and 06/2021 TULSA treatment for localized PCa was performed in 22 men (mean age: 67 ± 7 years, mean initial PSA: 6.8 ± 2.1 ng/ml, ISUP 1 in n = 6, ISUP 2 in n = 14 and 2 patients with recurrence after previous radiotherapy). Patients were selected by an interdisciplinary team, taking clinical parameters, histopathology from targeted or systematic biopsies, mpMRI and patients preferences into consideration. Patients were thoroughly informed about alternative treatment options and that TULSA is an individual treatment approach. High-intensity ultrasound was applied using an ablation device placed in the prostatic urethra. Heat-development within the prostatic tissue was monitored using MR-thermometry. Challenges during the ablation procedure and follow-up of oncologic and functional outcome of at least 12 months after TULSA treatment were documented.ResultsNo major adverse events were documented. In the 12 month follow-up period, no significant changes of urinary continence, irritative/obstructive voiding symptoms, bowel irritation or hormonal symptoms were reported according to the Expanded Prostate Cancer Index Composite (EPIC) score. Erectile function was significantly impaired 3–6 months (p < 0.01) and 9–12 months (p < 0.05) after TULSA. PSA values significantly decreased after therapy (2.1 ± 1.8 vs. 6.8 ± 2.1 ng/ml, p < 0.001). PCa recurrence rate was 23% (5/22 patients).ConclusionEstablishment of TULSA in clinical routine was unproblematic, short-term outcome seems to be encouraging. The risk of erectile function impairment requires elaborate information of the patient.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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