Presented by: Artem Alaverdyan Resident
Moscow City Hospital named after S.I. Spasokukotsky

Introduction

The aim of our trial was to assess treatment of localized prostate

cancer (PCa) using HIFU with «Focal One» device (with the possibility of fusion

technology combining intraoperative ultrasound and preoperative MRI data).

Materials

From November 2019 to April 2023, HIFU using the

"Focal One" device (EDAP, France) was performed in 145 patients with PCa.

Total ablation was carried out in 95 cases, focal ablation in 50 cases. The mean age

of the patients was 62.7 (51-80) years, total PSA level 9.3 (3.2-15.5) ng/ml,

prostate volume 32.0 (11-55) cc, Qmax 13.3 (6.3 - 36) ml/s, total IPSS score 7 (3-

25), IIEF-5 18 (4-25). Clinical stage T1cN0M0 was established in 118 patients,

T1bN0M0 in 10 and T2N0M0 in 17 patients. In 49 cases transurethral resection of

the prostate was performed 4-6 weeks before total HIFU.

Results

,

In all cases HIFU was performed under general anaesthesia. The average

operation time was 96 (56-147) minutes. The course of the postoperative period

was without any serious (Clavien-Dindo>2) complications. All patients received

antibiotic therapy (14 days) and treatment with alpha-adrenoblockers (1 month

after surgery). After urethral catheter removal on the 4th day, natural urination was

restored in all patients. Twenty five patients required an additional single

catheterization during 24 h after Foley removal. One year after HIFU 100 patients

were fully examined: mean total PSA level in patients who underwent total

ablation (n=65) was 0,96±0,11 ng/ml, IPSS score was 6,9±0,6 points (no

difference from the initial level), at control biopsy the prostatic adenocarcinoma

was revealed in 9 patients; in the remaining cases the prostatic tissue fibrosis was

revealed. Sexual function was not preserved in men who underwent total HIFU and

the median IIEF score remained the same in those after focal therapy. Evaluation

of other results is ongoing.

Conclusion

Treatment of localized prostate cancer using HIFU with the «Focal

One» robotic complex is promising and safe minimally invasive type of therapy,

which has demonstrated good oncological results after a short follow-up period.

Funding

Source of Funding – none.

Lead Authors

Dmitry Pushkar, MD,PhD, Academician of RAS, Professor
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov Department of Urology

Alexander Govorov, MD,PHD
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov Department of Urology

Konstantin Kolontarev, MD,PHD
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov Department of Urology

Alexander Vasilyev, MD
Moscow State University of Medicine and Dentistry named after A.I. Evdokimov Department of Urology