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Open Access 01-12-2017 | Research article

Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer

Authors: G. Hatiboglu, I. V. Popeneciu, M. Deppert, J. Nyarangi-Dix, B. Hadaschik, M. Hohenfellner, D. Teber, S. Pahernik

Published in: BMC Urology | Issue 1/2017

Abstract

Background

To evaluate quality of life, functional and oncological outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer.

Methods

One hundred thirty-one patients, treated with TURP and HIFU in a single institution were followed up for oncological and functional outcome. Oncological outcome was quantified by biochemical recurrence free survival using the Stuttgart and Phoenix criteria. Quality of life was assessed by usage of standardized QLQ-C30 and QLQ-PR25 questionnaires. In addition, functional questionnaires such as IPSS and IIEF-5 were used. Complications were assessed by the Clavien-Dindo classification.

Results

One hundred thirty-one patients with a mean age of 72.8 years (SD: 6.0) underwent HIFU for prostate cancer (29.0% low risk, 58.8% intermediate risk, 12.2% high risk). PSA nadir was 0.6 ng/ml (SD: 1.2) after a mean of 4.6 months (SD: 5.7). Biochemical recurrence free survival defined by Stuttgart criteria was 73.7%, 84.4% and 62.5% for low-, intermediate- and high-risk patients after 22.2 months. Complications were grouped according to Clavien-Dindo and occurred in 10.7% (grade II) and 11.5% (grade IIIa) of cases. 35.1% of patients needed further treatment for bladder neck stricture. Regarding incontinence, 14.3%, 2.9% and 0% of patients had de novo urinary incontinence grade I°, II° and III° and 3.8% urge incontinence due to HIFU treatment. Patients were asked for the ability to have intercourse: 15.8%, 58.6% and 66.7% of patients after non-, onesided and bothsided nervesparing procedure were able to obtain sufficient erection for intercourse, respectively. Regarding quality of life, mean global health score according to QLQ-C30 was 69.4%.

Conclusion

HIFU treatment for localized prostate cancer shows acceptable oncological safety. Quality of life after HIFU is better than in the general population and ranges within those of standard treatment options compared to literature. HIFU seems a safe valuable treatment alternative for patients not suitable for standard treatment.

Heidenreich A, Bellmunt J, Bolla M, Joniau S, Mason M, Matveev V, et al. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59(1):61–71. doi:10.1016/j.eururo.2010.10.039.CrossRefPubMed

Chaussy CG, Thuroff S. Transrectal high-intensity focused ultrasound for local treatment of prostate cancer: current role. Arch Esp Urol. 2011;64(6):493–506.PubMed

Madersbacher S, Marberger M. High-energy shockwaves and extracorporeal high-intensity focused ultrasound. J Endourol. 2003;17(8):667–72. doi:10.1089/089277903322518680.CrossRefPubMed

Madersbacher S, Pedevilla M, Vingers L, Susani M, Marberger M. Effect of high-intensity focused ultrasound on human prostate cancer in vivo. Cancer Res. 1995;55(15):3346–51.PubMed

Crouzet S, Chapelon JY, Rouviere O, Mege-Lechevallier F, Colombel M, Tonoli-Catez H, et al. Whole-gland ablation of localized prostate cancer with high-intensity focused ultrasound: oncologic outcomes and morbidity in 1002 patients. Eur Urol. 2014;65(5):907–14. doi:10.1016/j.eururo.2013.04.039.CrossRefPubMed

Osoba D. Health-related quality of life and cancer clinical trials. Ther Adv Med Oncol. 2011;3(2):57–71. doi:10.1177/1758834010395342.CrossRefPubMedPubMedCentral

Miller DC, Sanda MG, Dunn RL, Montie JE, Pimentel H, Sandler HM, et al. Long-term outcomes among localized prostate cancer survivors: health-related quality-of-life changes after radical prostatectomy, external radiation, and brachytherapy. J Clin Oncol. 2005;23(12):2772–80. doi:10.1200/JCO.2005.07.116.CrossRefPubMed

Drummond FJ, Kinnear H, O'Leary E, Donnelly, Gavin A, Sharp L. Long-term health-related quality of life of prostate cancer survivors varies by primary treatment. Results from the PiCTure (Prostate Cancer Treatment, your experience) study. J Cancer Surviv. 2015. doi:10.1007/s11764-014-0419-6.PubMed

Groenvold M, Klee MC, Sprangers MA, Aaronson NK. Validation of the EORTC QLQ-C30 quality of life questionnaire through combined qualitative and quantitative assessment of patient-observer agreement. J Clin Epidemiol. 1997;50(4):441–50.CrossRefPubMed

10.

Niezgoda HE, Pater JL. A validation study of the domains of the core EORTC quality of life questionnaire. Qual Life Res. 1993;2(5):319–25.CrossRefPubMed

11.

Chaussy C, Thuroff S. The status of high-intensity focused ultrasound in the treatment of localized prostate cancer and the impact of a combined resection. Curr Urol Rep. 2003;4(3):248–52.CrossRefPubMed

12.

D'Amico AV, Moul J, Carroll PR, Sun L, Lubeck D, Chen MH. Cancer-specific mortality after surgery or radiation for patients with clinically localized prostate cancer managed during the prostate-specific antigen era. J Clin Oncol. 2003;21(11):2163–72. doi:10.1200/JCO.2003.01.075.CrossRefPubMed

13.

D'Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998;280(11):969–74.CrossRefPubMed

14.

Ganzer R, Robertson CN, Ward JF, Brown SC, Conti GN, Murat FJ, et al. Correlation of prostate-specific antigen nadir and biochemical failure after high-intensity focused ultrasound of localized prostate cancer based on the Stuttgart failure criteria - analysis from the @-Registry. BJU Int. 2011;108(8 Pt 2):E196–201. doi:10.1111/j.1464-410X.2011.10091.x.CrossRefPubMed

15.

Roach 3rd M, Hanks G, Thames Jr H, Schellhammer P, Shipley WU, Sokol GH, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65(4):965–74. doi:10.1016/j.ijrobp.2006.04.029.CrossRefPubMed

16.

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.CrossRefPubMedPubMedCentral

17.

Pfeiffer D, Berger J, Gross AJ. Single application of high-intensity focused ultrasound as a first-line therapy for clinically localized prostate cancer: 5-year outcomes. BJU Int. 2012;110(11):1702–7. doi:10.1111/j.1464-410X.2012.11375.x.CrossRefPubMed

18.

Warmuth M, Johansson T, Mad P. Systematic review of the efficacy and safety of high-intensity focussed ultrasound for the primary and salvage treatment of prostate cancer. Eur Urol. 2010;58(6):803–15. doi:10.1016/j.eururo.2010.09.009.CrossRefPubMed

19.

Blana A, Rogenhofer S, Ganzer R, Lunz JC, Schostak M, Wieland WF, et al. Eight years' experience with high-intensity focused ultrasonography for treatment of localized prostate cancer. Urology. 2008;72(6):1329–33. doi:10.1016/j.urology.2008.06.062. discussion 33–4.CrossRefPubMed

20.

Ganzer R, Fritsche HM, Brandtner A, Brundl J, Koch D, Wieland WF, et al. Fourteen-year oncological and functional outcomes of high-intensity focused ultrasound in localized prostate cancer. BJU Int. 2013;112(3):322–9. doi:10.1111/j.1464-410X.2012.11715.x.CrossRefPubMed

21.

Chaussy CG, Thuroff SF. Robotic high-intensity focused ultrasound for prostate cancer: what have we learned in 15 years of clinical use? Curr Urol Rep. 2011;12(3):180–7. doi:10.1007/s11934-011-0184-2.CrossRefPubMed

22.

Chaussy C, Thuroff S. Results and side effects of high-intensity focused ultrasound in localized prostate cancer. J Endourol. 2001;15(4):437–40. doi:10.1089/089277901300189501. discussion 47–8.CrossRefPubMed

23.

Burke RM, Evans JD. Avanafil for treatment of erectile dysfunction: review of its potential. Vasc Health Risk Manag. 2012;8:517–23. doi:10.2147/VHRM.S26712.PubMedPubMedCentral

24.

Shoji S, Nakano M, Nagata Y, Usui Y, Terachi T, Uchida T. Quality of life following high-intensity focused ultrasound for the treatment of localized prostate cancer: a prospective study. Int J Urol. 2010;17(8):715–9. doi:10.1111/j.1442-2042.2010.02568.x.CrossRefPubMed

25.

Schwarz R, Hinz A. Reference data for the quality of life questionnaire EORTC QLQ-C30 in the general German population. Eur J Cancer. 2001;37(11):1345–51.CrossRefPubMed

Title: Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer
Authors: G. Hatiboglu
I. V. Popeneciu
M. Deppert
J. Nyarangi-Dix
B. Hadaschik
M. Hohenfellner
D. Teber
S. Pahernik
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Urology / Issue 1/2017
Electronic ISSN: 1471-2490
DOI: https://doi.org/10.1186/s12894-017-0198-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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