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    Focal cryo vs. focal HIFU: Similar oncologic outcomes

    Difference in failure rates not statistically significant, researchers report

    London—Oncologic outcomes are similar using focal cryotherapy and focal high-intensity focused ultrasound (HIFU) for treatment of localized prostate cancer, French urologists reported at the World Congress of Endourology and SWL in London.  

    Read: AUA, others fight measure penalizing docs who order PSA

    Their study analyzed prospectively collected data from patients who were followed for at least 1 year after being treated with focal therapy through the Paris-based Institut Mutualiste Montsouris (IMM) department of urology. Control biopsies were obtained routinely at 1 year in all patients and then after 2 or 3 years, regardless of PSA, according to the treating physician’s discretion.

    There were 91 men who had undergone focal cryotherapy and 58 who had focal HIFU. Median follow-up was 22 months for the cryotherapy group and 19 months for HIFU patients. Any positive follow-up biopsy was considered treatment failure, and it was found in 43 men (47%) who had cryotherapy and 18 of the men (31%) who had HIFU. The difference in rates was not statistically significant.

    Also see: Can Gleason 7 cancer be low-risk disease?

    In the cryotherapy and HIFU groups, the positive biopsy was ipsilateral in 14 (15.4%) and eight (13.8%) men, respectively; contralateral in 14 (15.4%) and seven (12.1%) men, respectively; and bilateral in 15 (16.5%) and three men (5.2%), respectively. Fifteen men in the cryotherapy group and four in the HIFU group had a Gleason 7 positive biopsy and underwent salvage radical prostatectomy. Thirteen cryotherapy patients and three HIFU patients had one ipsilateral Gleason 6 positive biopsy. Of those 16 patients, nine underwent repeat focal therapy and seven chose active surveillance.

    Next: "Our experience indicates that failure rates are comparable after focal cryotherapy and focal HIFU."

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