Partial gland ablation with high-intensity focal ultrasound impact on urinary function and quality of life: Our initial experience
Ioana Fugaru1, Gautier Marcq2, Alexis Rompré-Brodeur1, Andrew Meng3, Oleg Loutochin1, George Loutochin1, Maurice Anidjar1, Franck Bladou4, Raphael Sanchez-Salas1.
1Department of Surgery, Division of Urology, McGill University, Montreal, QC, Canada; 2Department of Urology, Claude Huriez Hospital, CHU Lille, Lille, France; 3Faculty of Medicine, McGill University, Montreal, QC, Canada; 4Department of Urology, Claude Huriez Hospital, Pellegrin University Hospital, Bordeaux, France
Introduction: Partial gland ablation (PGA) using high-intensity focal ultrasound (HIFU) is emerging as an option for localized prostate cancer (PCa). Our goal was to present the urinary side effects and the impact of PGA on quality of life (QoL) in the initial prospective cohort of men who underwent PGA at our institution.
Methods: Twenty-five men with a diagnosis of low/intermediate PCa were enrolled prospectively in a single Canadian center between 2013 and 2016. Patients completed questionnaires at baseline, one, three, six, and 12 months after PGA. Statistical tests were performed using GraphPrism 8.0.
Results: Median age was 64 years. Baseline median International Index of Erectile Function-15 (IIEF-15) score was 50 and decreased to 18 at one month (p=0.0323). At three months, IIEF-15 score returned to baseline (51) and remained stable at six and 12 months (51; 52). At baseline, 16% of patients were delighted and 44% were pleased with their urinary condition, on the International Prostate Symptom Score (IPSS) QoL question. At one month, only 8% were delighted and 40% were pleased (p=0.5668). This increased to 32% delighted and 44% pleased at three months (p=0.0296). IPSS median at baseline was 8. This deteriorated at one month (12), and then improved to 7, 6, and 5 at three, six, and 12 months (p=0.0459). On the UCLA-Expanded Prostate Cancer Index Composite urinary function, 76% of patients had scores between 81 and 100, which decreased to 36% at one month (p=0.0313) but returned to 68% at three month. Concerning QoL, baseline median visual analogue scale (VAS) in EQ-5D questionnaire was 85 and was similar at followup (82.5, 90, 80, and 85, respectively, p=0.4002). Similarly, median Functional Assessment Cancer Therapy-Prostate (FACT-P) score at baseline was 136 and was stable at 134, 142, 135, and 131 at followup times, respectively (p=0.9418).
Conclusions: In our initial experience with PGA, patients had slight deterioration in urinary and erectile function at one month but then returned to baseline. Men did not have significant perturbation of QoL during followup.
