Table 4.
Actual population studied in each primary series with the histologic, biochemical, and cancer long-term outcomes
| Reference | Technology | Type of ablation | PSA level, ng/ml | Gleason score at preoperative biopsy (%) | Risk classification, D’Amico or NCCN, no. (%) | Follow-up | Postfocal histology (reason) | Presence of any cancer, actual (%) | Presence of clinically significant cancer | bDFS, % | PSA kinetics* | Secondary treatment, actual (%) | Metastatic disease, actual (%) | Mortality: % |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Madersbacher et al. [15] | HIFU | Midline target or unilateral ablation of TRUS-visible tumours | Mean: 24 (range: 2–82.8) | NR | NR | Few hours (mean/median: NR) | RP | 29/29 (100) | NR | NR | NR | NR | NR | Overall and cancer-specific survival: 100 |
| Zlotta et al. [16] | RITA | Multifocal | NR | NR | NR | Mean/median: NR (range: 0 d–3 mo) | RP | 14/14 (100) | NR | NR | NR | NR | NR | Overall and cancer-specific survival: 100 |
| Beerlage et al. [17] | HIFU | Total or subtotal hemiablation | Mean: 10.8 (range: 3.5–20) | NR | NR | Median: 8.5 d (range: 7–12) | RP | 13/14 (93) 4/14 (29) had residual tumor in treated area |
NR | NR | NR | 0/14 (0) | 0/14 (0) | Overall and cancer-specific survival: 100 |
| Souchon et al. [18] | HIFU | Focal ablation of peripheral zone | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR | NR |
| Moore et al. [19] | PDT | Focal with ipsilateral peripheral zone ablation | Median: 6.95 (range: 1.9–15) | 3 + 3: 6 (100) | NR | NR | TRUS sextant biopsy (protocol) | 6/6 (100) | NR | NR | NR | 4/6 (67) redo PDT 5/6 (83) salvage treatment (3 EBRT, 1 brachytherapy, 1 cryotherapy) |
0/6 (0) | Overall and cancer-specific survival: 100 |
| Bahn et al. [20] | Cryoablation | Hemiablation | Mean: 4.95 (range or SD: NR) | ≤6: 23 (74) 7: 8 (26) |
NR | Mean: 70 mo (range: 2–107) | TRUS sextant biopsy plus target biopsy of suspicious areas on Doppler (protocol) | 1/25 (4) | NR | 92.9 | NR | 1/31 (4) redo cryoablation | 0/25 (0) | Overall survival: 96 Cancer-specific survival: 100 |
| Onik et al. [21] | Cryoablation | Focal | Mean: 8.3 (range or SD: NR) | NR | Low: 26 (48) Intermediate: 20 (36) High: 9 (16) |
Mean: 3.6 yr (range: 1–10) | NR | Only patients having biopsy: 4/30 (13) All patients: 4/55 (7) |
NR | 95 (3 yr) | Mean: 2.4 (SD: NR) | 4/55 (7) redo cryoablation | NR | Overall and cancer-specific survival: 100 |
| Ellis et al. [22] | Cryoablation | Hemiablation plus contralateral peripheral zone (hockey stick) | Mean: 7.2 (SD: 4.7) | ≤6: NR (78.3) 7: NR (20) ≥8 NR (1.7) |
Low: 40 (66.7) Intermediate: 14 (23.3) High: 6 (10) |
Median: 12 mo (range: 3–36) | NR | Only patients having biopsy: 14/35 (40); 1/35 (3) in treated side All patients: 14/60 (23); 1/60 (1.7) in treated side |
NR | 80.4 | Median: 1.7 (IQR: NR) | 11/60 (18) redo cryoablation | 0/60 (0) | Overall and cancer-specific survival: 100 |
| Muto et al. [23] | HIFU | Hemiablation plus contralateral peripheral zone (hockey stick) | Median: 5.4 (range: 0.2–25.1) | Unknown: 2 (6.9) ≤6: 16 (55.2) 7: 6 (20.7) ≥8: 5 (17.2) |
NR | Median: 34 mo (range: 8–45) | TRUS sextant (protocol) |
At 6 mo: 3/28 (10.7) At 12 mo: 4/17 (23.5) |
NR | 2-yr Low risk: 83.3 Intermediate risk: 53.6 |
36-mo mean: 1.89 (SD: 1.51) | 7/29 (24) ADT | NR | Overall and cancer-specific survival: 100 |
| Murat et al. [24] | HIFU | Hemiablation | NR | NR | Low: 33 (59) Intermediate: 23 (41) |
Median: 42 mo (NR) | NR | NR | NR | 3 yr: 76 5 yr: 60 |
Nadir after first HIFU: mean: 0.5 (SD: NR) Nadir after redo HIFU: mean: 0.47 (SD: NR) |
19/56 (34) redo HIFU | NR | NR |
| Lindner et al. [25] | Photothermal laser | Focal | Mean: 5.7 (SD: 1.1) |
3 + 3: 12 (100) | Low risk: 12 (100) | 6 mo | TRUS 10-core biopsy plus 2 cores guided in the treated area (protocol) | 6/12 (50) 4/12 (33) in treated area |
2/12 (17) | NR | NR | 1/12 (8) RP | 0/12 (0) | Overall and cancer-specific survival: 100 |
| Lindner et al. [26] | Photothermal laser | Focal | Median: 4.2 (range: 2.9–14.8) | 3 + 3: 2 (50) 4 + 3: 2 (50) |
NR | 1 wk | RP | 4/4 (100) with no residual tumor in treated area | NR | NR | NR | NR | NR | Overall and cancer-specific survival: 100 |
| Raz et al. [27] | Photothermal laser | Focal | Median: 3.76 (range: 2.74–4.79) | 3 + 3: 2 (100) | Low: 2 (100) | ≤1 mo | NR | NR | NR | NR | NR | 0/2 (0) | NR | Overall and cancer-specific survival: 100 |
| Truesdale et al. [28] | Cryoablation | Hemiablation | Mean: 6.54 (SD: 4.87) | ≤6: 50 (65) 7: 25 (32) 8: 2 (3) |
Low: 44 (57) Intermediate: 31 (40) High: 2 (3) |
Median: 24 mo (0–87) | TRUS 12-core biopsy (for cause) | Only patients having biopsy: 10/22 (45.5) 3/22 (14) in treated area All patients: 10/77 (13); 3/77 (3.9) in treated area |
NR | 72.7 | Mean: 1.23 (SD: 1.38) | NR | NR | Overall and cancer-specific survival: 100 |
| El Fegoun et al. [29] | HIFU | Hemiablation | Mean: 7.3 (range: 2.6–10) | ≤3 + 3: 10 (83) 3 + 4: 2 (17) |
NR | Median: 10.6 yr (range: 7.5–11.1) | TRUS sextant (protocol) | 1/12 (8) | 0/12 | 5 yr: 90 10 yr: 38 |
Median: 1.5 (range: 0.1–6.8) | 1/12 (8) redo HIFU 4/12 (33) ADT |
0/12 (0) | Overall survival: 83 Cancer-specific survival: 100 |
| Ahmed et al. [30] | HIFU | Hemiablation | Median: 7.3 (range: 3.4–11.8) | NR | Low: 5 (25) Intermediate: 15 (75) | 12 mo | TRUS biopsy of the treated side (protocol) | 2/19 (11) | 0/19 | NR | 12-mo mean: 1.5 (SD: 1.3) | 1/20 (5) redo HIFU | 0/19 (0) | Overall and cancer-specific survival: 100 |
| Ward et al. [31] | Cryoablation | NR | 1149 (99%) available <4: 211 (18%) 4 to <10: 782 (68%) 10 to <20: 126 (11%) >20: 30 (3%) |
1148 (99) available ≤6: 844 (74) 7: 240 (21) ≥8: 64 (5) |
1157 (99) available Low: 541 (47) Intermediate: 473 (41) High: 143 (12) |
Mean: 21.1 mo (SD: 19.7) |
NR |
Only patients having biopsy: 43/163 (26.3) All patients: 43/1160 (3.7) |
NR | 3 yr: 75.7 | NR | NR | NR | NR |
| Tay et al. [32] | MRI-guided HIFU | Uni- or multifocal | NR | NR | NR | NR | NR | 0/1 | NR | NR | NR | NR | NR | NR |
| Chopra et al. [33] | MRI-guided HIFU | Peripheral zone | Mean: 6.2 (range: 2.7–13.1) | 3 + 3: 2 (25) 3 + 4: 4 (50) 4 + 3: 2 (25) |
NR | <2 h | RP | 8/8 (100) | 6/8 (75) | NR | NR | NR | 0/8 (0) | Overall and cancer-specific survival: 100 |
| Bahn et al. [34]** | Cryoablation | Hemiablation | Median: 5.4 (range: 0.01–20) | 3 + 3: 30 (41) 3 + 4: 25 (34) 4 + 3: 18 (25) |
Low: 24 (33) Intermediate: 49 (67) | Median: 3.7 yr (range: 1–8.5) | TRUS sextant plus target biopsy of suspicious areas (protocol) | 12/48 (25) 11 positive biopsy results in untreated side; 1 treated side |
5/48 (10) |
NR | 36-mo mean: 2.1 (SD: 3.8) | 2/73 (3) redo cryoablation 1/73 (1.4) brachytherapy, 1/73 (1.4) ADT |
0/48 (0) | Overall and cancer-specific survival: 100 |
| Ahmed et al. [35] | HIFU | Unilateral, bilateral or midline ablation | Median: 6.6 (range: 5.4–7.7) | 3 + 3: 13 (32) 3 + 4: 24 (59) 4 + 3: 4 (10) |
Low: 11 (27) Intermediate: 26 (63) High: 4 (10) |
12 mo | TRUS biopsy of treated area (protocol) | 9/39 (23) | 3/39 (8) | NR | Median: 1.9 (IQR: 0.8–3.3) | 4/41 (10) redo HIFU | 0/39 (0) | Overall survival: 97.7 Cancer-specific survival: 100 |
| Dickinson et al. [36]** | HIFU | Hemiablation, unifocal or multifocal | NR | 3 + 3: 31 (35) 3 + 4: 50 (57) 4 + 3: 7 (8) |
NR | Median: 32 mo (range: 24–69) | TRUS biopsy of treated area (protocol) | 20/72 (28) | 10/72 (14) | Phoenix 71/87 (82) Stuttgart 57/87 (66) |
NR | NR/87 (20) redo HIFU 4/87 (5) salvage EBRT |
NR | NR |
| Nguyen et al. [37] | MRI-guided brachytherapy | Peripheral zone | Median: 5.0 (IQR: 3.8–6.9) |
3 + 3: 280 (88) 3 + 4: 38 (12) |
Low: 265 (83) Intermediate: 53 (17) |
5.1 yr (IQR: 2.8–7.3) | TRUS 12-core biopsy (for cause) | Only patients having biopsy: 17/24 (71) All patients: 17/318 (5.3) |
NR | Phoenix: 5 yr: 91.5 8 yr: 78.1 Phoenix and PSAV: >0.75/yr 5 yr: 91.9 8 yr: 86.2 |
NR | NR | 1/318 (0.3) | Overall and cancer-specific survival: 99.7 |
| Napoli et al. [38] | MRI-guided HIFU | Focal | Median: 8.8 | 3 + 3: 3 (60) 3 + 4: 2 (40) |
NR | Mean: 9 mo (range: 7–14) | RP | 5/5 (100) | NR | NR | NR | NR | NR | NR |
| Barret et al. [39] | HIFU: 21 (20) Brachytherapy: 12 (11) Cryoablation: 50 (47) PDT: 23 (22) |
Hemiablation | Mean: 6.1 (IQR: 5–8.1) | 3 + 3: 106 (100) | Low: 106 (100) | Median: 9 mo (range: 6–15) | NR | NR | NR | NR | 12-mo median: 2.7 (IQR: 1–4.4) | NR | NR | NR |
PSA = prostate-specific antigen; NCCN = National Comprehensive Cancer Network; bDFS = biochemical disease-free survival; HIFU = high intensity focused ultrasound; TRUS = transrectal ultrasound; NR = not reported; RP = radical prostatectomy; RITA = radiofrequency interstitial tumor ablation; PDT = photodynamic therapy; EBRT = external beam radiotherapy; SD = standard deviation; IQR = interquartile range; ADT = androgen-deprivation therapy; MRI = magnetic resonance imaging; PSAV = prostate-specific antigen velocity.
*
At last follow-up unless otherwise stated.
**
This series partially overlaps with one previously reported.