Evaluating long-term outcomes of MRI-guided ultrasound ablation for prostate cancer.

This study was carried out to assess the long-term safety and effectiveness of magnetic resonance imaging (MRI)-guided transurethral ultrasound ablation (TULSA) in patients with localized prostate cancer. The authors found that TULSA was safe and effective, with preserved quality of life.

Prostate cancer is one of the most common forms of cancer experienced by men. TULSA uses MRI scans to target ultrasound waves in order to destroy prostate cancer through the penis. This causes minimal damage to the surrounding area. A previous analysis showed that TULSA is associated with reduced prostate volume and good urinary and sexual outcomes after 1 year in men with localized prostate cancer. However, the longer-term safety and effectiveness of this treatment are still not known.

There were 22 patients with localized prostate cancer included in this trial. All patients received MRI-guided TULSA. Patients were followed up for 3 years through prostate biopsy (tissue sample) and MRI scans. Prostate-specific antigen (PSA; a blood marker of prostate cancer recurrence) samples were taken 2 times a year. Also, patients completed questionnaires that evaluated patients' quality of life.

74% of patients were alive without PSA increase at 3 years. 76% of patients did not need additional therapies at 3 years. PSA levels decreased to an average of 0.33 ng/L and were stable at 0.8ng/L after 3-years. 

Most side effects were mild to medium. Quality of life was stable at 3 years. Urinary and bowel function remained stable at 3 years follow-up. The erectile function had recovered by 1-year and was stable at 3-years.

The authors concluded that TULSA was safe, and allowed for precise and predictable PSA and biopsy outcomes. The authors also found that functional abilities were not affected. 

This was an extended follow-up of a small phase I study. Larges studies are needed. This study was funded by Profound Medical, the developer of TULSA.