Current Findings on High Intensity Focused Ultrasound (HIFU) Thomas J Polascik, MD, FACS Professor of Surgery
|
|
- Shona Harrell
- 6 years ago
- Views:
Transcription
1 Current Findings on High Intensity Focused Ultrasound (HIFU) Thomas J Polascik, MD, FACS Professor of Surgery
2 Outline Whole gland abla6on selec6on and outcomes Focal abla6on - Eligibility and pa6ent selec6on Outcomes Salvage HIFU Oncological outcomes Predictors of success Func6onal outcomes
3 General SelecEon Criteria Gland volume < 40cc ADT, TUR? Minimal calcifica6ons Anterior vs posterior lesions Volume of 6ssue ablated Post- treatment FU PSA, imaging, biopsy
4 Whole Gland - PaEent CharacterisEcs Author # patients Age PSA Volume (ml) Stage GS Gland Downsizing Thuroff (2013) 704 Mean: 68 Mean: 10 Mean: 22 T1: 12% T2: 89% 6-67% 7 28% 8 5% ADT: 30% TUR: 75% Ganzer (2013) 538 Mean: 68 Mean: 11 Mean: 21 T1: 41% T2: 55% T3: 4% 6-75% 7 16% 8 8% **1.3% - unk ADT: 36% TUR: NR Crouzet (2013) 1,002 Median: 71 Median: 7.7 Median: 23 T1: 52% T2: 45% T3: 3% 6-55% 7 35% 8 8% **1.5% - ukn ADT: 39% TUR: 94% Uchida (2015) 918 Median: 68 Median: 8.6 Median: 22 T1: 61% T2: 36% T3: 4% 6 49% 7 37% 8 14% ADT: 59% TUR: 15% Dickinson (2016) 569 Median: 65 Median: 7 Mean: 40 T1: 29% T2: 55% T3: 15% 6-52% ADT: 13% 7 Dr. Thomas 43% Polascik TUR: 21% 8 4% **1.2%-ukn
5 Whole Gland Cancer Outcomes Author FU (yrs) PSA Nadir (ng/ ml) bdfs Biopsy Survival Thuroff (2013) Mean 5.3 Mean: years: 84-92% 10 years: 60-68% NR At 10 years: CSS: 99% Ganzer (2013) Mean 8.1 Mean: years: 81% 10 years: 61% 76/297 (26%) OS: 86% CSS: 97% Crouzet (2013) Median 6.4 Median: years: Low risk: 76% Int. risk: 63% High risk: 57% 289/774 (37%) At 10 years: OS: 80% CSS: 97% Uchida (2015) Median 6.5 NR 5 years: 57% 10 years: 49% 96/758 (12.7%) At 10 years: OS: 88.6% DSS: 97% Dickinson (2016) Median 3.6 Median: years: Low risk: 87% Int. risk: 63% High risk: 58% 85/180 (47%) At 5 years: OS: 95%
6 Whole Gland FuncEonal Outcomes Author Erectile function (%potent) Continence Complications Thuroff (2013) In previously potent: 55% >3 months incontinence: 3% Total: 16% (UTI, BOO, fistula, BNC) Ganzer (2013) In previously potent: 25% Incontinence: Grade 1: 14% Grade 2: 2% Grade 3: 0.7% UTI: 10% Fistula: 0.7% BOO: 28% Crouzet (2013) In those with IIEF-5 17: 42% Incontinence: Grade 1: 19% Grade 2/3: 5% UTI: 4% Fistula: 0.4% BOO: 17% Stenosis: 9% Uchida (2015) In IIEF-5 <8: 6 months: 58% 12 months: 51% 24 months: 35% Incontinence: 2.3% Stricture: 20% Epididymitis: 6% Fistula: 0.1% Dickinson (2016) In previously potent: 39% Incontinence in those who were pad free: 12% Dr. UTI: Thomas 8% Polascik Epididymo-orchitis: 3% Fistula: 0.13%
7 Primary Focal AblaEon- PaEent SelecEon Eligibility Low risk: If pa6ent does not wish to go on AS Intermediate risk - Comprehensive staging is necessary Biomarkers Bx Imaging High risk: If metasta6c evalua6on is nega6ve * Donaldson IA, Alonzi R, BarraY D, et al. Focal therapy: pa6ents, interven6ons, and outcomes- - a report from a consensus mee6ng. Eur Urol. 2015;67(4):771-7.
8 Primary Focal AblaEon- PaEent SelecEon Means for pa6ent selec6on: mpmri * : Ideal : 3T If 1.5 T endorectal coil is essential Minimum sequences: T1, T2, DCE and DWI Experienced, specialized radiologist should report results No consensus on MRI being an alternative for saturation biopsies TTMB ** : In men with +Bx and - mpmri *Muller BG, van den Bos W, Brausi M, et al. Role of mul6parametric magne6c resonance imaging (MRI) in focal therapy for prostate cancer: a Delphi consensus project. BJU Int. 2014;114(5): **Crawford ED, Rove KO, Barqawi AB, et al. Clinical- pathologic correla6on between transperineal mapping biopsies of the prostate and three- dimensional reconstruc6on of prostatectomy specimens. Prostate. 2013;73(7):
9 mpmri and PaEent SelecEon The preferred tool for: Diagnosis Planning FU The downside * : mpmri underes6mates the true border of prostate cancer by 0.5 cm 2 Overall sensi6vity of only 47% US Food and Drug Administra6on (FDA). Public Workshop AUA- FDA- SUO Workshop on Par6al Gland Abla6on for Prostate Cancer, May 17, FDA website.
10 Author Patients Inclusion Criteria Staging SelecEon Barret ( ) 21 Unilateral 3 + cores GG 6 PSA <10 ct2a TVS Bx for focal HIFU in recent Van Velthoven ( ) 50 Ahmed ( ) 56 Unilateral, prostate <40cm 3 Any GG PSA < 15 ct2 Life expectancy at least 5 years Index and secondary lesion GG 4+3 PSA 20 T3a mpmri mpmri; TTMB or TRUS series: Chapelon ( ) 10 Monofocal NR Feijoo ( ) 67 Rischmann ( ) 111 Unilaterial <33% + bx GG 3+4 PSA <15 ct2a Unilateral 2 adjacent sextants Gleason 3+4 T2 mpmri mpmri
11 Primary Focal AblaEon - Outcomes Author FU duration (months) PSA nadir Bx recurrence Preserved Erectile function Continence Complications Barret ( ) Median: 9 (6-15) Median: 3.1 NR NR (med IIEF5 14) 100% AUR: 5 Van Velthoven ( ) Mean: 40 Mean: 0.9 6/8 (1 ipsilateral, 2 bilateral, 1 contralateral) 80% 94% UTI: 3 AUR: 4 Stricture: 2 Ahmed ( ) 12 Median: /52 (treated side -18) 77% Only pad free: 92% Pad and leak free: 88% Dysuria: 9 Hematuria: 36 UTI: 10 Fistula: 1 TURP: 1 TURBN: 2 Chapelon ( ) NR Mean: 3.5 0/10 80% 100% NR Feijoo ( ) Median: 12 Median: /67 (treated side - 11) 52% 100% UTI: 4 AUR: 4 TURP: 2 Rischmann ( ) Mean: 30 Mean: /101 (treated side- 12; 5 clinically significant) 78% 97% UTI: 18 Hematuria: 5 AUR: 5 Stricture: 1 TURP: 3
12 HIFU cohort: N = 55 Unilateral disease mpmri and mpmri -TRUS fusion RALP: pt2a Outcomes: No significant difference in salvage therapy free survival Better functional outcomes with HIFU
13 Salvage HIFU AblaEon Author Oncological control Continence Complications Murat (2009) PFS at 3 yrs: Low risk 53% Int. risk 42% High risk 25% 52% continent Artificial urinary sphincter 11% Ahmed (2012) bdfs at 3 yrs: 63% Pad and leak free 64% Pad free only 87% Fistula - 1 Baco (2014) PFS at 24 m 52% Pad free 75% Delayed pubic bone osteitis 2 (pubovesical fistula -1)
14 N=418 Mean FU 3.5 yrs Mean Pre- PSA 6.8 Mean PSA nadir 0.19ng/ml At 7 years: OSS 72% CSS 82% MFS 81% Salvage HIFU AblaEon Crouzet S, Blana A, Murat FJ, et al. Salvage high- intensity focused ultrasound (HIFU) for locally recurrent prostate cancer aner failed radia6on therapy: Mul6- ins6tu6onal analysis of 418 pa6ents. BJU Int. 2017
15 Factors associated with salvage HIFU failure and recurrence: History of ADT Pre- salvage GS Pre- salvage PSA Crouzet S, Blana A, Murat FJ, et al. Salvage high- intensity focused ultrasound (HIFU) for locally recurrent prostate cancer aner failed radia6on therapy: Mul6- ins6tu6onal analysis of 418 pa6ents. BJU Int. 2017
16 N=50 Biochemical failure 70% Metastasis - 24% Progression in 76% PFS: o 1 year 72% o 3 year 40% o 5 year 31% OS at 5 years 87% Post opera6ve PSA nadir was the only significant predictor for PFS or OS Salvage HIFU AblaEon Shah TT, Peters M, Kanthabalan A, et al. PSA nadir as a predic6ve factor for biochemical disease- free survival and overall survival following whole- gland salvage HIFU following radiotherapy failure. Prostate Cancer Prosta6c Dis. 2016;19(3):311-6.
17 Salvage HIFU AblaEon N= 81 Prospec6ve Mean FU 53 mos PSA nadir - <0.5 ng/ml OS 88% CSS 94%
18 Salvage HIFU FuncEonal Outcomes and ComplicaEons (Recent Series) Author Erectile function Incontinence Complications Shah et al (2016) Non significant median 3 point decrease in IIEF-5 score 31% Fistula 6% Osteonecrosis (pubic symphysis) 6% Bladder neck incision for BOO 54% Siddiqui et al (2016) IIEF-5 decreased from baseline Severe 3.7% Clavien 1 83% Clavien 2 8.6% Fistula 3.7% Crouzet (2017)* NR Grade II/III from 32% to 19% Artificial urinary sphincter from 15 to 5% BOO/stenosis 30 to 15% Urethro-rectal fistula from 9 to 0.6% * Reduc6on in incon6nence and complica6on rate following the introduc6on of specific post radia6on parameters
19 Whole gland : Summary Good CSS but high post- HIFU posi6ve biopsy rate High rates bladder neck contracture that require interven6on Focal abla6on: mpmri necessary for treatment planning and FU Short and mid term outcomes seem promising Longer FU and prospec6ve trials are necessary Salvage abla6on: PSA nadir associated with brfs and PFS: Techniques to minimize side effects needed
S Crouzet, O Rouvière, JY Chapelon, F Mege, X martin, A Gelet
S Crouzet, O Rouvière, JY Chapelon, F Mege, X martin, A Gelet Why HIFU? Efficacy demonstrated Real time control of the target Early control of the necrosis area is possible with MRI or TRUS using contrast
More informationHigh Intensity Focused Ultrasounds for the treatment of Prostate Cancers Clinical update November D. Maruzzi - L. Ruggera
High Intensity Focused Ultrasounds for the treatment of Prostate Cancers Clinical update November 2014 D. Maruzzi - L. Ruggera HIFU development Second prototype 1995-2000 Integrated Imaging 2006-2010 1993
More informationDepartment of Urology, Cochin hospital Paris Descartes University
Technical advances in the treatment of localized prostate cancer Pr Michaël Peyromaure Department of Urology, Cochin hospital Paris Descartes University Introduction Curative treatments of localized prostate
More informationProstate MRI: Screening, Biopsy, Staging, and Ablation
Prostate MRI: Screening, Biopsy, Staging, and Ablation Scott Eggener, M.D. Associate Professor of Surgery- Urologic Oncology Director- Prostate Cancer Program University of Chicago International Prostate
More informationMR-US Fusion Guided Biopsy: Is it fulfilling expectations?
MR-US Fusion Guided Biopsy: Is it fulfilling expectations? Kenneth L. Gage MD, PhD Assistant Member Department of Diagnostic Imaging and Interventional Radiology 4 th Annual New Frontiers in Urologic Oncology
More informationRole of surgery. Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam
Role of surgery Theo M. de Reijke MD PhD FEBU Department of Urology Academic Medical Center Amsterdam Surgery and alternative treatments Radical prostatectomy Open Laparoscopic Robot-assisted Temperature
More informationPathologists Perspective on Focal Therapy: The Role of Mapping Biopsies and Markers
Pathologists Perspective on Focal Therapy: The Role of Mapping Biopsies and Markers M. Scott Lucia, MD Professor and Vice Chair of Anatomic Pathology Chief of Genitourinary and Renal Pathology Dept. of
More informationProstate Focal Therapy: What s on the Horizon? Thomas J Polascik, MD FACS
Prostate Focal Therapy: What s on the Horizon? Thomas J Polascik, MD FACS Current State of Prostate Focal Therapy Patient Selection Focal Ablation Technology and Technique Follow-up/ Surveillance after
More informationProstate Biopsy in 2017
Prostate Biopsy in 2017 Bob Djavan, MD, PhD Professor and Chairman, Department of Urology, Rudolfinerhaus Foundation Hospital,Vienna, Austria Director Vienna Urology foundation Board member Scientific
More informationRadical Prostatectomy: Management of the Primary From Localized to Oligometasta:c Disease
Radical Prostatectomy: Management of the Primary From Localized to Oligometasta:c Disease Disclosures I do not have anything to disclose Sexual function causes moderate to severe distress 2 years after
More informationCase Discussions: Prostate Cancer
Case Discussions: Prostate Cancer Andrew J. Stephenson, MD FRCSC FACS Chief, Urologic Oncology Glickman Urological and Kidney Institute Cleveland Clinic Elevated PSA 1 54 yo, healthy male, family Hx of
More informationEffective Date: 11/1/2018 Section: SUR Policy No: 420 Medical Policy Committee Approved Date: 8/18; 9/18
PROVIDENCE HEALTH PLANS MEDICAL (HIFU) (All Lines of Business Except Medicare) Effective Date: 11/1/2018 Section: SUR Policy No: 420 Medical Policy Committee Approved Date: 8/18; 9/18 11/1/18 Medical Officer
More informationSalvage HDR Brachytherapy. Amit Bahl Consultant Clinical Oncologist The Bristol Cancer Institute, UK
Salvage HDR Brachytherapy Amit Bahl Consultant Clinical Oncologist The Bristol Cancer Institute, UK Disclosures Still No financial disclosures! Limited personal experience of HDR Brachy as salvage option
More informationIndex Lesion Only. Prof. Phillip D Stricker
Index Lesion Only Prof. Phillip D Stricker Financial and Other Disclosures Off-label use of drugs, devices, or other agents: None Data from IRB-approved human research is presented I have the following
More informationProstate Cancer Innovations in Surgical Strategies Update 2007!
Prostate Cancer Innovations in Surgical Strategies Update 2007! Curtis A. Pettaway, M.D. Professor Department of Urology The University of Texas M. D. Anderson Cancer Center Radical Prostatectomy Pathologic
More information2/14/09. Why Discuss this topic? Managing Local Recurrences after Radiation Failure. PROSTATE CANCER Second Treatment
Why Discuss this topic? Mack Roach III, MD Professor and Chair Radiation Oncology UCSF Managing Local Recurrences after Radiation Failure 1. ~15 to 75% of CaP pts recur after definitive RT. 2. Heterogeneous
More informationPSA nadir post LDR Brachytherapy and early Salvage Therapy. Dr Duncan McLaren UK & Ireland Users Group Meeting 2016
PSA nadir post LDR Brachytherapy and early Salvage Therapy Dr Duncan McLaren UK & Ireland Users Group Meeting 2016 Differences in PSA relapse rates based on definition used PSA ng/ml Recurrence ASTRO Recurrence
More informationPSA is rising: What to do? After curative intended radiotherapy: More local options?
Klinik und Poliklinik für Urologie und Kinderurologie Direktor: Prof. Dr. H. Riedmiller PSA is rising: What to do? After curative intended radiotherapy: More local options? Klinische und molekulare Charakterisierung
More informationManagement of Locally Reccurent Renal Cell Carcinoma. Jose A. Karam, MD, FACS Assistant Professor Department of Urology
Management of Locally Reccurent Renal Cell Carcinoma Jose A. Karam, MD, FACS Assistant Professor Department of Urology DefiniAons Defini&ve treatment Aiming for cure Abla&on therapy Radiofrequency abla&on
More informationProstatectomy as salvage therapy. Cases. Paul Cathcart - Guy s & St Thomas NHS Trust, London
Prostatectomy as salvage therapy Cases Paul Cathcart - Guy s & St Thomas NHS Trust, London Attributes of brachytherapy appeal to young men who place high utility on genitourinary function At risk of
More informationFocal Brachytherapy. Juanita Crook MD FRCPC Professor Radia;on Oncology University of Bri;sh Columbia
Focal Brachytherapy Juanita Crook MD FRCPC Professor Radia;on Oncology University of Bri;sh Columbia Why focal therapy? Screening frequently diagnoses favourable risk with a low disease burden Appropriate
More informationHigh-Intensity Focused Ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: predictors of disease response
ORIGINAL ARTICLE Vol. 44 (2): 248-257, March - Abril, 2018 doi: 10.1590/S1677-558.IBJU.2017.0025 High-Intensity Focused Ultrasound (HIFU) as salvage therapy for radio-recurrent prostate cancer: predictors
More informationSuper-active surveillance : MRI ultrasound fusion biopsy and ablation for less invasive management of prostate cancer
Review Article on Interventional Radiology in Glands Super-active surveillance : MRI ultrasound fusion biopsy and ablation for less invasive management of prostate cancer Jonathan B. Bloom 1, Samuel A.
More informationIrreversible Electroporation for the Treatment of Recurrent Prostate Cancer
Irreversible Electroporation for the Treatment of Recurrent Prostate Cancer after prostatectomy, radiation therapy and HiFU R. Schwartzberg, E. Günther, N. Klein, S. Zapf, R. El-Idrissi, J. Cooper, B.
More informationCancer. Description. Section: Surgery Effective Date: October 15, 2016 Subsection: Original Policy Date: September 9, 2011 Subject:
Subject: Saturation Biopsy for Diagnosis, Last Review Status/Date: September 2016 Page: 1 of 9 Saturation Biopsy for Diagnosis, Description Saturation biopsy of the prostate, in which more cores are obtained
More informationThe importance of maximal restoration of peri-prostatic support
Providing the best evidence for each surgical option in organ confined prostate cancer The importance of maximal restoration of peri-prostatic support A. Mottrie ORSI-Academy Melle Belgium OLV Hospital
More informationMRI in the Enhanced Detection of Prostate Cancer: What Urologists Need to Know
MRI in the Enhanced Detection of Prostate Cancer: What Urologists Need to Know Michael S. Cookson, MD, FACS Professor and Chair Department of Urology Director of Prostate and Urologic Oncology University
More informationHow to deal with patients who fail intracavitary treatment
How to deal with patients who fail intracavitary treatment A. Heidenreich Department of Urology Non-surgical therapy of PCA IMRT SEEDS IGRT HDR-BRACHY HIFU CRYO LDR - Brachytherapy Author Follow-up bned
More informationPROSTATE CANCER SURVEILLANCE
PROSTATE CANCER SURVEILLANCE ESMO Preceptorship on Prostate Cancer Singapore, 15-16 November 2017 Rosa Nadal National Cancer Institute, NIH Bethesda, USA DISCLOSURE No conflicts of interest to declare
More informationNewer Aspects of Prostate Cancer Underwriting
Newer Aspects of Prostate Cancer Underwriting Presented By: Jack Swanson, M.D. Keith Hoffman, NFP Moments Made Possible Objectives To review and discuss Conflicting messages about PSA testing Cautions
More informationNew research in prostate brachytherapy
New research in prostate brachytherapy Dr Ann Henry Associate Professor in Clinical Oncology University of Leeds and Leeds Cancer Centre PIVOTAL boost opening 2017 To evaluate - The benefits of pelvic
More informationProstate Cancer Local or distant recurrence?
Prostate Cancer Local or distant recurrence? Diagnostic flowchart Vanessa Vilas Boas Urologist VFX Hospital FEBU PSA - only recurrence PSA recurrence: 27-53% of all patients undergoing treatment with curative
More informationFOCAL THERAPY PROSTATE SEED BRACHYTHERAPY
FOCAL THERAPY PROSTATE SEED BRACHYTHERAPY DR. JOSEPH BUCCI MBBS,FRACP,FRANZCR ST. GEORGE CANCER CARE CENTRE PATIENT 47 2005 66 year old Recently remarried - old childhood sweetheart PSA 6.2, ct1c, Gleason
More informationAblatherm Integrated Imaging HIFU Treatment of Low Risk, Localized Prostate Cancer
Ablatherm Integrated Imaging HIFU Treatment of Low Risk, Localized Prostate Cancer P130003 Gastroenterology and Urology Devices Panel Meeting July 30, 2014 CI-1 Presenters Cary Robertson, MD Associate
More informationProstate MRI for local staging and surgical planning in prostate cancer
Prostate MRI for local staging and surgical planning in prostate cancer 15th Annual Floyd A. Fried Advances in Urology Symposium June 23, 2017 Ray Tan, MD, MSHPM Assistant Professor Disclosures None Objectives
More informationHigh-Intensity Focused Ultrasound as Salvage Therapy for Patients With Recurrent Prostate Cancer After Radiotherapy
www.kjurology.org http://dx.doi.org/10.4111/kju.2014.55.2.91 Original Article - Urological Oncology http://crossmark.crossref.org/dialog/?doi=10.4111/kju.2014.55.2.91&domain=pdf&date_stamp=2014-2-1 High-Intensity
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of focal therapy using high-intensity focused ultrasound for localised prostate
More informationABLATHERM HIFU THE CANADIAN EXPERIENCE. WILLIAM L. OROVAN McMASTER UNIVERSITY MAPLE LEAF HIFU
ABLATHERM HIFU THE CANADIAN EXPERIENCE WILLIAM L. OROVAN McMASTER UNIVERSITY MAPLE LEAF HIFU PROCEDURE 1. Spinal Anaesthetic/IV Sedation 2. Right Lateral Decubitus Position 3. Transrectal Probe 4. Catheter
More informationMR-TRUS Fusion Biopsy
MR-TRUS Fusion Biopsy Silvan Boxler Department of Urology Prostate cancer mortality according to risk groups Prevention of overdiagnosis and overtreatment Rider J, Eur Urol 2013 MR-TRUS Fusion Biopsy /
More informationJournée industrielle PRIMES, 12 juin Nicolas Guillen, EDAP TMS France
Multi modality imaging for prostate cancer targeting and treatment Journée industrielle PRIMES, 12 juin 2014 Nicolas Guillen, EDAP TMS France Focal One device Focal One is the first device dedicated to
More informationAnatomic Imaging of Prostate Cancer
Masoom Haider, MD, FRCP(C) Professor of Radiology, University of Toronto Clinician Scientist, Ontario Institute of Cancer Research Senior Scientist, Sunnybrook Research Institute Chief, Dept of Medical
More informationLDR Monotherapy vs. HDR Monotherapy
Abstract No. 1234 LDR Monotherapy vs. HDR Monotherapy Is it time for LDR to retire? Gerard Morton 2 LDR Seed Brachytherapy First 2000 LDR patients from BCCA Low and Intermediate Risk LDR Implant Morris
More informationCytoreductive Radical Prostatectomy for de Novo Metastatic Prostate Cancer
Cytoreductive Radical Prostatectomy for de Novo Metastatic Prostate Cancer Timothy G. Wilson, MD Professor and Chair of Urology John Wayne Cancer Institute Santa Monica, California Disclosures I am on
More informationFOCAL THERAPY OF PROSTATE CANCER : WHERE ARE WE? MICHAEL MARBERGER PROFESSOR AND CHAIRMAN DEPARTMENT OF UROLOGY MEDICAL UNIVERSITY OF VIENNA
FOCAL THERAPY OF PROSTATE CANCER : WHERE ARE WE? MICHAEL MARBERGER PROFESSOR AND CHAIRMAN DEPARTMENT OF UROLOGY MEDICAL UNIVERSITY OF VIENNA pt2a GL.SC. 6 (3+3) IS TREATMENT OF ENTIRE GLAND NEEDED? MR
More informationComparative morbidity of ablative energy-based salvage treatments for radio-recurrent prostate cancer
Original research Comparative morbidity of ablative energy-based salvage treatments for radio-recurrent prostate cancer Khurram M. Siddiqui, MBBS, MSc, FRCS, FEBU; * Michele Billia, MD; * Andrew Williams,
More informationIt is time to abandon transrectal prostate biopsy for perineal biopsy. Con Argument
It is time to abandon transrectal prostate biopsy for perineal biopsy Con Argument Erik P. Castle M.D., F.A.C.S. Professor of Urology Mayo Clinic Department of Urology Phoenix, AZ None Financial Disclosures
More information3/22/2014. Goals of this Presentation: in 15 min & 5 min Q & A. Radiotherapy for. Localized Prostate Cancer: What is New in 2014?
3/22/ Goals of this Presentation: in 15 min & 5 min Q & A 1. Potency Preservation. a. Dosimetric considerations Radiotherapy for b. Drugs 2. Update on duration of short term ADT Mack III, MD Professor
More informationOutcomes of salvage radical prostatectomy following more than one failed local therapy
Original Article - Urological Oncology https://doi.org/10.4111/icu.2018.59.3.152 pissn 2466-0493 eissn 2466-054X Outcomes of salvage radical prostatectomy following more than one failed local therapy Arjun
More information11/10/2015. Prostate cancer in the U.S. Multi-parametric MRI of Prostate Diagnosis and Treatment Planning. NIH estimates for 2015.
Multi-parametric MRI of Prostate Diagnosis and Treatment Planning Temel Tirkes, M.D. Associate Professor of Radiology Director, Genitourinary Radiology Indiana University School of Medicine Department
More informationThe SPARED CRN meeting
The SPARED CRN meeting FDA, Washington 5/3/2018 To Develop and Regulate Modern PCa-Care: a Secured, Integrated, Transversal Vision from Europe. Pr Roland van Velthoven, MD, PhD Dr Antoine Leroy, PhD Koelis
More informationRecurrence of prostate cancer after HIFU. Proposal of a novel predictive index
Acta Biomed 2018; Vol. 89, N. 2: 220-226 DOI: 10.23750/abm.v89i2.6730 Mattioli 1885 Original article Recurrence of prostate cancer after HIFU. Proposal of a novel predictive index Umberto Maestroni 1,
More informationProstate Cancer: 2010 Guidelines Update
Prostate Cancer: 2010 Guidelines Update James L. Mohler, MD Chair, NCCN Prostate Cancer Panel Associate Director for Translational Research, Professor and Chair, Department of Urology, Roswell Park Cancer
More informationPaul F. Schellhammer, M.D. Eastern Virginia Medical School Urology of Virginia Norfolk, Virginia
Paul F. Schellhammer, M.D. Eastern Virginia Medical School Urology of Virginia Norfolk, Virginia Virginia - Chesapeake Bay Landfall: Virginia Beach, April 29 th, 1607 PSA Failure after Radical Prostatectomy
More informationImaging of prostate cancer local recurrences : why and how?
Imaging of prostate cancer local recurrences : why and how? Olivier Rouvière Department of Urinary and Vascular Imaging Hospices Civils de Lyon Lyon - France 1. Preliminary Remarks Preliminary Remarks
More informationManagement of LUTS after TURP and MIT
Management of LUTS after TURP and MIT Hong Sup Kim Konkuk University TURP & MIT TURP : Gold standard MIT TUIP TUNA TUMT HIFU LASER Nd:YAG, ILC, HoLRP, KTP LUTS after TURP and MIT Improved : about 70% Persistent
More informationda Vinci Prostatectomy
da Vinci Prostatectomy Justin T. Lee MD Director of Robotic Surgery Urology Associates of North Texas (UANT) USMD Prostate Cancer Center (www.usmdpcc.com) Prostate Cancer Facts Prostate cancer Leading
More informationAdjuvant and Salvage Radiation for Prostate Cancer. Savita Dandapani, MD, PhD
Adjuvant and Salvage Radiation for Prostate Cancer Savita Dandapani, MD, PhD DISCLOSURES I am a consultant for Reflexion, receive funding from Bayer, and on the Speaker s Bureau with Astra Zeneca. Post-prostatectomy
More informationBPH with persistently elevated PSA 아주대학교김선일
BPH with persistently elevated PSA 아주대학교김선일 PSA in BPH: present status AUA & EAU BPH guideline: PSA: recommended test AUA practice guideline committee. J Urol 2003;170:530 Madersbacher. Eur Urol 2004;46:547
More informationRadiation Therapy for Prostate Cancer. Resident Dept of Urology General Surgery Grand Round November 24, 2008
Radiation Therapy for Prostate Cancer Amy Hou,, MD Resident Dept of Urology General Surgery Grand Round November 24, 2008 External Beam Radiation Advances Improving Therapy Generation of linear accelerators
More informationAccuracy of post-radiotherapy biopsy before salvage radical prostatectomy
Accuracy of post-radiotherapy biopsy before salvage radical prostatectomy Joshua J. Meeks, Marc Walker*, Melanie Bernstein, Matthew Kent and James A. Eastham Urology Service, Department of Surgery and
More informationA schematic of the rectal probe in contact with the prostate is show in this diagram.
Hello. My name is William Osai. I am a nurse practitioner in the GU Medical Oncology Department at The University of Texas MD Anderson Cancer Center in Houston. Today s presentation is Part 2 of the Overview
More informationPost Prostatectomy Radia/on. Bill McLaughlin MD University of Michigan
Post Prostatectomy Radia/on Bill McLaughlin MD University of Michigan No disclosures COI Important Disclosure I am the most pro-surgery radia/on oncologist in the universe Example: If a 45 year old man
More informationMultiparametric MR Imaging of the Prostate after Treatment of Prostate Cancer
Multiparametric MR Imaging of the Prostate after Treatment of Prostate Cancer RadioGraphics 2018; 38:437 449 Pritesh Patel, MD Melvy S. Mathew, MD Igor Trilisky, MD Aytekin Oto, MD, MBA Jeffrey S. Klein,
More informationFocal Therapy is a Fool s Paradise : The whole prostate must be treated!
Focal Therapy is a Fool s Paradise : The whole prostate must be treated! Ofer Yossepowitch, MD Head, Department of Urology Tel Aviv Sourasky Medical Center Preaching against focal therapy in a focal therapy
More informationCLINICAL WORKSHOP IMAGE-GUIDED HDR BRACHYTHERAPY OF PROSTATE CANCER
CLINICAL WORKSHOP IMAGE-GUIDED HDR BRACHYTHERAPY OF PROSTATE CANCER Klinikum Offenbach Nucletron April 27 th 28 th, 2014 History HDR Protocols for Boost and Monotherapy, Results, Logistics and Practical
More informationProstate MRI Hamidreza Abdi, MD,FEBU Post Doctoral Fellow Vancouver Prostate Centre UBC Department of Urologic Sciences May-20144
Prostate MRI Hamidreza Abdi, MD,FEBU Post Doctoral Fellow Vancouver Prostate Centre UBC Department of Urologic Sciences May-20144 Objectives: Detection of prostate cancer the need for better imaging What
More informationThe benefit of a preplanning procedure - view from oncologist. Dorota Kazberuk November, 2014 Otwock
The benefit of a preplanning procedure - view from oncologist Dorota Kazberuk 21-22 November, 2014 Otwock Brachytherapy is supreme tool in prostate cancer management with a wide range of options in every
More informationUnderstanding the risk of recurrence after primary treatment for prostate cancer. Aditya Bagrodia, MD
Understanding the risk of recurrence after primary treatment for prostate cancer Aditya Bagrodia, MD Aditya.bagrodia@utsouthwestern.edu 423-967-5848 Outline and objectives Prostate cancer demographics
More informationProstate Cancer. David Wilkinson MD Gulfshore Urology
Prostate Cancer David Wilkinson MD Gulfshore Urology What is the Prostate? Male Sexual Gland Adds nutrients and fluids for sperm This fluid is added to sperm during ejaculation Urethra (urine channel)
More informationNATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE
NATIONAL INSTITUTE FOR HEALTH AND CARE EXCELLENCE INTERVENTIONAL PROCEDURES PROGRAMME Interventional procedure overview of irreversible electroporation for treating prostate cancer The prostate is a small
More informationHigh-Intensity Focused Ultrasound (HIFU) for Prostate Cancer
HIFU technology shows promise as an alternative to radiation therapy for patients with localized prostate cancer. Monique Gueudet-Bornstein. Laissez les Bon Temps Rouler [Let the Good Times Roll]. New
More informationConsensus and Controversies in Cancer of Prostate BASIS FOR FURHTER STUDIES. Luis A. Linares MD FACRO Medical Director
BASIS FOR FURHTER STUDIES Main controversies In prostate Cancer: 1-Screening 2-Management Observation Surgery Standard Laparoscopic Robotic Radiation: (no discussion on Cryosurgery-RF etc.) Standard SBRT
More informationProstate Cancer and BPH Management Revolutionised. Marc Laniado MD FEBU FRCS(Urol)! Consultant Urologist
Prostate Cancer and BPH Management Revolutionised Marc Laniado MD FEBU FRCS(Urol)! Consultant Urologist Prostate cancer is common and causes death worldwide Prostate Cancer BPH incidence by Age 2 Conventional
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationClinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline Very Low-/Low-Risk Disease
Clinically Localized Prostate Cancer: AUA/ASTRO/SUO Guideline Very Low-/Low-Risk Disease Jeffrey A. Cadeddu, MD Professor, Department of Urology UT Southwestern Medical Center Vice-Chair, AUA/ASTRO/SUO
More informationMini-Invasive Treatment in Urological Diseases Dott. Alberto Saita Responsabile Endourologia Istituto Clinico Humanitas - Rozzano
Dipartimento di Urologia Direttore Prof. Giorgio Guazzoni Mini-Invasive Treatment in Urological Diseases Dott. Alberto Saita Responsabile Endourologia Istituto Clinico Humanitas - Rozzano alberto.saita@humanitas.it
More informationClinical Case Conference
Clinical Case Conference Intermediate-risk prostate cancer 08/06/2014 Long Pham Clinical Case 64 yo man was found to have elevated PSA of 8.65. TRUS-biopies were negative. Surveillance PSA was 7.2 in 3
More informationPROSTATE CANCER BRACHYTHERAPY. Kazi S. Manir MD,DNB,PDCR RMO cum Clinical Tutor Department of Radiotherapy R. G. Kar Medical College
PROSTATE CANCER BRACHYTHERAPY Kazi S. Manir MD,DNB,PDCR RMO cum Clinical Tutor Department of Radiotherapy R. G. Kar Medical College Risk categorization Very Low Risk Low Risk Intermediate Risk High Risk
More informationScreening and Risk Stratification of Men for Prostate Cancer Metastasis and Mortality
Screening and Risk Stratification of Men for Prostate Cancer Metastasis and Mortality Sanoj Punnen, MD, MAS Assistant Professor of Urologic Oncology University of Miami, Miller School of Medicine and Sylvester
More informationAdam Raben M.D. Helen F Graham Cancer Center
Adam Raben M.D. Helen F Graham Cancer Center Is the biopsy sample representative of the extent of the disease in your patient with clinically low-risk prostate cancer? BIOPSY RP registry (n=8095) 3+3=6
More informationProstate Case Scenario 1
Prostate Case Scenario 1 H&P 5/12/16: A 57-year-old Hispanic male presents with frequency of micturition, urinary urgency, and hesitancy associated with a weak stream. Over the past several weeks, he has
More informationPROSTATE MRI. Dr. Margaret Gallegos Radiologist Santa Fe Imaging
PROSTATE MRI Dr. Margaret Gallegos Radiologist Santa Fe Imaging Topics of today s talk How does prostate MRI work? Definition of multiparametric (mp) MRI Anatomy of prostate gland and MRI imaging Role
More informationCryosurgery as primary treatment for localized prostate cancer
Int Urol Nephrol (2011) 43:1089 1094 DOI 10.1007/s11255-011-9952-7 UROLOGY ORIGINAL PAPER Cryosurgery as primary treatment for localized prostate cancer Huibo Lian Hongqian Guo Weidong Gan Xiaogong Li
More information2011 PROSTATE BRACHYTHERAPY STUDY
20 PROSTATE BRACHYTHERAPY STUDY CRITERIA Patients receiving prostate brachytherapy at Cox from 2002-200. In this study, we will look at patients with the following prognostic features: PSA
More informationState-of-the-art: vision on the future. Urology
State-of-the-art: vision on the future Urology Francesco Montorsi MD FRCS Professor and Chairman Department of Urology San Raffaele Hospital Vita-Salute San Raffaele University Milan, Italy Disclosures
More informationPoor reproducibility of PIRADS score in two multiparametric MRIs before biopsy in men with elevated PSA
https://doi.org/10.1007/s00345-018-2252-4 TOPIC PAPER Poor reproducibility of PIRADS score in two multiparametric MRIs before biopsy in men with elevated PSA Stig Müller 1,2 Gunder Lilleaasen 1 Tor Erik
More informationHigh intensity focused ultrasound uses high energy
Phase I/II Trial of High Intensity Focused Ultrasound for the Treatment of Previously Untreated Localized Prostate Cancer Michael O. Koch,*, Thomas Gardner, Liang Cheng, Russell J. Fedewa, Ralf Seip and
More informationBest Papers. F. Fusco
Best Papers UROLOGY F. Fusco Best papers - 2015 RP/RT Oncological outcomes RP/RT IN ct3 Utilization trends RP/RT Complications Evolving role of elnd /Salvage LND This cohort reflects the current clinical
More informationGleason Scoring System 2017 JASREMAN DHILLON, MD ASSOCIATE PROFESSOR, DEPARTMENT OF ANATOMIC PATHOLOGY, MOFFITT CANCER CENTER, TAMPA, FLORIDA
Gleason Scoring System 2017 JASREMAN DHILLON, MD ASSOCIATE PROFESSOR, DEPARTMENT OF ANATOMIC PATHOLOGY, MOFFITT CANCER CENTER, TAMPA, FLORIDA Learners Objectives u Latest changes per ISUP 2014 that impact
More informationWhere are we with PSA screening?
Where are we with PSA screening? Faculty/Presenter Disclosure Rela%onships with commercial interests: None Disclosure of Commercial Support This program has received no financial support. This program
More informationProstate MRI: Who needs it?
Prostate MRI: Who needs it? Fergus Coakley MD, Professor of Radiology and Urology, Vice Chair for Clinical Services, Chief of Abdominal Imaging, UCSF Abdominal Imaging Magnetic Resonance Science Center
More informationTreatment of Invasive Bladder Cancer in the Elderly and Frail Pa9ent
Treatment of Invasive Bladder Cancer in the Elderly and Frail Pa9ent Jehonathan H Pinthus MD, Ph.D, FRCSC Associate Professor Department of Surgery/Urology McMaster University Life expectancy Current age
More informationCitation for published version (APA): Scheltema, M. J. V. (2018). Focal therapy: Changing the landscape of prostate cancer treatments
UvA-DARE (Digital Academic Repository) Focal therapy Scheltema, M.J.V. Link to publication Citation for published version (APA): Scheltema, M. J. V. (2018). Focal therapy: Changing the landscape of prostate
More informationBrachytherapy for Prostate Cancer
Brachytherapy for Prostate Cancer Who should be thinking about this and why... Juanita Crook Professor Radiation Oncology University of Toronto Princess Margaret Hospital Many options watchful waiting?
More informationProstate Cancer MRI. Accurate Diagnosis and Treatment. PSA to Prostate MRI. for patients and curious doctors
6 Prostate Cancer MRI Accurate Diagnosis and Treatment PSA to Prostate MRI for patients and curious doctors Samuel Aronson, M.D. Vincent Pelsser, M.D. Franck Bladou, M.D. Armen Aprikian, M.D. & Marc Emberton,
More informationFocal Salvage HIFU in radiorecurrent prostate cancer
Focal Salvage HIFU in radiorecurrent prostate cancer Kanthabalan A.* [1, 2], Peters M* [3], Van Vulpen M [3], McCartan N. [1,2], Hindley R [4], Moore C.M. [1,2], Arya M. [2], Emberton M. [1,2], Ahmed H.U.
More informationQ&A. Overview. Collecting Cancer Data: Prostate. Collecting Cancer Data: Prostate 5/5/2011. NAACCR Webinar Series 1
Collecting Cancer Data: Prostate NAACCR 2010-2011 Webinar Series May 5, 2011 Q&A Please submit all questions concerning webinar content through the Q&A panel Overview NAACCR 2010-2011 Webinar Series 1
More informationHow to detect and investigate Prostate Cancer before TRT
How to detect and investigate Prostate Cancer before TRT Frans M.J. Debruyne Professor of Urology Andros Men s Health Institutes, The Netherlands Bruges, 25-26 September 2014 PRISM Recommendations for
More informationGuidelines for the Management of Prostate Cancer West Midlands Expert Advisory Group for Urological Cancer
Guidelines for the Management of Prostate Cancer West Midlands Expert Advisory Group for Urological Cancer West Midlands Clinical Networks and Clinical Senate Coversheet for Network Expert Advisory Group
More informationAllinaHealthSystems 1
2018 Dimensions in Oncology Genitourinary Cancer Disclosures I have no financial or commercial relationships relevant to this presentation. Matthew O Shaughnessy, MD, PhD Director of Urologic Oncology
More information