Live-Op-HIFU bei Prostatakrebs T. Egner
Recently four different systematic HIFU Ablation der Prostata assessing the role of HIFU in prostate cancer have been published. Hence, there is no evidence to show that HIFU improves or provides equivalent oncologic outcomes, whether in reference to progression-free survival, biochemical-free survival or overall survival. Accordingly, there is a lack of evidence to demonstrate that HIFU offers an improved side effect profile compared to surgery or radiation.
Unfortunately, most HIFU series have short follow-up, and although over 20 observational series have been reported, most have been performed by a small number of different study groups suggesting the possibility of publication bias. Several study confounders also limit the usefulness of HIFU literature making efficacy analyses and side effect profile comparisons between HIFU and other modalities challenging. In fact, there is little evidence to define the indications or contraindications of retreatment and sparse data revealing the safe limits of retreatments.
HIFU Ablation der Prostata endpoint comparison between modalities even more difficult is the heterogeneous definition of biochemical failure within the HIFU literature, with some series using radiation-validated prostate-specific antigen failure criteria Phoenix and ASTRO criteria and others reporting criteria specifically developed, but not yet validated, for HIFU HIFU Ablation der Prostata definition.
Until a validated definition of biochemical failure is defined, HIFU treated patients must be followed with post-treatment transrectal ultrasound-guided prostate biopsy. These positive biopsy rates show that a considerable number of patients will continue to harbour malignancy within their HIFU Ablation der Prostata however, the impact of HIFU on the efficacy and safety of secondary salvage treatment is unclear.
Currently, there are no long-term published data from salvage external-beam series, but there are many reports that show that the combination of radiation and HIFU has a significant impact on erectile function and continence. Finally, there is no clear evidence that HIFU treatment provides improved quality of life or improves long-term morbidity compared to either surgery or radiation.
Patients deserve efficacious oncologic treatments that provide minimal impact in quality of life, as well as providing minimal morbidity. However, there is no clear evidence that HIFU provides equivalent oncologic outcomes or improves long-term side effect profile when compared to surgery or brachytherapy.
High-intensity focused ultrasound treatment must be evaluated more thoroughly to ensure that cancer HIFU Ablation der Prostata and HIFU Ablation der Prostata quality of life are not compromised. Thus, HIFU should remain a treatment that is used in the context of a clinical trial and should not be considered a standard treatment option for men with localized prostate cancer.
Competing interests: None declared. This paper has been peer-reviewed. National Center for Biotechnology InformationU. Can Urol Assoc J.
Alan I. Author information Copyright and License information Disclaimer. Correspondence: Dr. This article HIFU Ablation der Prostata been cited by other articles in PMC. Footnotes Competing interests: None declared. References 1. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. Validity updated Accessed November 29, NCCN clinical practice guidelines in oncology: prostate cancer. J Natl Compr Canc Netw.
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