Universität zu Köln

Klotz, Laurence, Pavlovich, Christian P., Chin, Joseph, Hatiboglu, Gencay, Koch, Michael, Penson, David, Raman, Steven, Oto, Aytekin, Futterer, Jurgen, Serrallach, Marc, Relle, James, Lotan, Yair, Heidenreich, Axel, Bonekamp, David, Haider, Masoom, Tirkes, Temel, Arora, Sandeep, Macura, Katarzyna J., Costa, Daniel N., Persigehl, Thorsten, Pantuck, Allan J., Bomers, Joyce, Burtnyk, Mathieu, Staruch, Robert and Eggener, Scott (2021). Magnetic Resonance Imaging-Guided Transurethral Ultrasound Ablation of Prostate Cancer. J. Urol., 205 (3). S. 769 - 778. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1527-3792

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Abstract

Purpose: Magnetic resonance imaging-guided transurethral ultrasound ablation uses directional thermal ultrasound under magnetic resonance imaging thermometry feedback control for prostatic ablation. We report 12-month outcomes from a prospective multicenter trial (TACT). Materials and methods: A total of 115 men with favorable to intermediate risk prostate cancer across 13 centers were treated with whole gland ablation sparing the urethra and apical sphincter. The co-primary 12-month endpoints were safety and efficacy. Results: In all, 72 (63%) had grade group 2 and 77 (67%) had NCCN(R) intermediate risk disease. Median treatment delivery time was 51 minutes with 98% (IQR 95-99) thermal coverage of target volume and spatial ablation precision of +/- 1.4 mm on magnetic resonance imaging thermometry. Grade 3 adverse events occurred in 9 (8%) men. The primary endpoint (U.S. Food and Drug Administration mandated) of prostate specific antigen reduction >= 75% was achieved in 110 of 115 (96%) with median prostate specific antigen reduction of 95% and nadir of 0.34 ng/ml. Median prostate volume decreased from 37 to 3 cc. Among 68 men with pretreatment grade group 2 disease, 52 (79%) were free of grade group 2 disease on 12-month biopsy. Of 111 men with 12-month biopsy data, 72 (65%) had no evidence of cancer. Erections (International Index of Erectile Function question 2 score 2 or greater) were maintained/regained in 69 of 92 (75%). Multivariate predictors of persistent grade group 2 at 12 months included intraprostatic calcifications at screening, suboptimal magnetic resonance imaging thermal coverage of target volume and a PI-RADS(TM) 3 or greater lesion at 12-month magnetic resonance imaging (p <0.05). Conclusions: The TACT study of magnetic resonance imaging-guided transurethral ultrasound whole gland ablation in men with localized prostate cancer demonstrated effective tissue ablation and prostate specific antigen reduction with low rates of toxicity and residual disease.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Klotz, Laurence UNSPECIFIED UNSPECIFIED UNSPECIFIED Pavlovich, Christian P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chin, Joseph UNSPECIFIED UNSPECIFIED UNSPECIFIED Hatiboglu, Gencay UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Penson, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Raman, Steven UNSPECIFIED UNSPECIFIED UNSPECIFIED Oto, Aytekin UNSPECIFIED UNSPECIFIED UNSPECIFIED Futterer, Jurgen UNSPECIFIED UNSPECIFIED UNSPECIFIED Serrallach, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Relle, James UNSPECIFIED UNSPECIFIED UNSPECIFIED Lotan, Yair UNSPECIFIED UNSPECIFIED UNSPECIFIED Heidenreich, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Bonekamp, David UNSPECIFIED UNSPECIFIED UNSPECIFIED Haider, Masoom UNSPECIFIED UNSPECIFIED UNSPECIFIED Tirkes, Temel UNSPECIFIED UNSPECIFIED UNSPECIFIED Arora, Sandeep UNSPECIFIED UNSPECIFIED UNSPECIFIED Macura, Katarzyna J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Costa, Daniel N. UNSPECIFIED UNSPECIFIED UNSPECIFIED Persigehl, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Pantuck, Allan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bomers, Joyce UNSPECIFIED UNSPECIFIED UNSPECIFIED Burtnyk, Mathieu UNSPECIFIED UNSPECIFIED UNSPECIFIED Staruch, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Eggener, Scott UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-604600
DOI:	10.1097/JU.0000000000001362
Journal or Publication Title:	J. Urol.
Volume:	205
Number:	3
Page Range:	S. 769 - 778
Date:	2021
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1527-3792
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INTENSITY FOCUSED ULTRASOUND; FOCAL THERAPY; OUTCOMES; TISSUE; INDEX; BIOPSIES Multiple languages Urology & Nephrology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60460