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Yang CH, Chen LH, Lin YS, Hsu CY, Tung MC, Huang SW, Wu CH, Ou YC. Incorporating VR-RENDER Fusion Software in Robot-Assisted Partial Prostatectomy: The First Case Report. Curr Oncol 2023; 30:1699-1707. [PMID: 36826092 PMCID: PMC9955092 DOI: 10.3390/curroncol30020131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 02/03/2023] Open
Abstract
Currently, the active surveillance of men with favorable intermediate-risk localized prostate cancer (PCa) is a longstanding controversy, in terms of their oncological outcomes, and radical prostatectomy would constitute a similar concern of overtreatment, regarding its functional outcomes. Thus, focal therapy could be considered in men belonging to favorable intermediate-risk group. Among all focal therapies, high-intensity focused ultrasound (HIFU) was the most studied methodology in clinical trials. Although HIFU provided better functional outcomes than radical prostatecomy, the oncological outcomes were inferior in men with intermediate-risk localized PCa. Two articles have been published discussing the feasibility and clinical outcomes of robot-assisted partial prostatectomy (RAPP), and both the functional and oncological outcomes were superior than those with HIFU. However, the rate of positive surgical margins (PSMs) was reported as high in the literature. Here, we present a case of favorable intermediate-risk localized PCa with an isolated tumor at the anterior apex. After reconstructing a personal three-dimensional (3D) image, we utilized it in a 3D image-guided precise excise, followed by intraoperative frozen specimen review. We found that this method may present a resolution to the high PSM rate documented in the current literature regarding RAPP. This method merits further study with a well-designed prospective study.
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Affiliation(s)
- Che-Hsueh Yang
- Division of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung 435, Taiwan
| | - Li-Hsun Chen
- Asian Institute of Telesurgery, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan
- Correspondence: (L.-H.C.); (Y.-C.O.)
| | - Yi-Sheng Lin
- Division of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung 435, Taiwan
| | - Chao-Yu Hsu
- Division of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung 435, Taiwan
| | - Min-Che Tung
- Division of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung 435, Taiwan
| | - Shih-Wei Huang
- Asian Institute of Telesurgery, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan
- Division of General Surgery, Department of Surgery, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan
| | - Chi-Hsiang Wu
- Asian Institute of Telesurgery, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan
- Department of Urology, Chang Bing Show Chwan Memorial Hospital, Changhua 505, Taiwan
| | - Yen-Chuan Ou
- Division of Urology, Department of Surgery, Tungs’ Taichung MetroHarbor Hospital, Taichung 435, Taiwan
- Correspondence: (L.-H.C.); (Y.-C.O.)
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52
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Translational Bioinformatics for Human Reproductive Biology Research: Examples, Opportunities and Challenges for a Future Reproductive Medicine. Int J Mol Sci 2022; 24:ijms24010004. [PMID: 36613446 PMCID: PMC9819745 DOI: 10.3390/ijms24010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/16/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Since 1978, with the first IVF (in vitro fertilization) baby birth in Manchester (England), more than eight million IVF babies have been born throughout the world, and many new techniques and discoveries have emerged in reproductive medicine. To summarize the modern technology and progress in reproductive medicine, all scientific papers related to reproductive medicine, especially papers related to reproductive translational medicine, were fully searched, manually curated and reviewed. Results indicated whether male reproductive medicine or female reproductive medicine all have made significant progress, and their markers have experienced the progress from karyotype analysis to single-cell omics. However, due to the lack of comprehensive databases, especially databases collecting risk exposures, disease markers and models, prevention drugs and effective treatment methods, the application of the latest precision medicine technologies and methods in reproductive medicine is limited.
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Scheltema MJ, Geboers B, Blazevski A, Doan P, Katelaris A, Agrawal S, Barreto D, Shnier R, Delprado W, Thompson JE, Stricker PD. Median 5-year outcomes of primary focal irreversible electroporation for localised prostate cancer. BJU Int 2022. [PMID: 36495481 DOI: 10.1111/bju.15946] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To evaluate longer-term oncological and functional outcomes of focal irreversible electroporation (IRE) as primary treatment for localised clinically significant prostate cancer (csPCa) at a median follow-up of 5 years (up to 10 years). PATIENTS AND METHODS All patients that underwent focal IRE as primary treatment for localised PCa between February 2013 and August 2021 with a minimum 12 months of follow-up were analysed. Follow-up included 6-month magnetic resonance imaging (MRI) and standardised transperineal saturation template ± targeted biopsies at 12 months, and further biopsies in the case of clinical suspicion on serial imaging and/or prostate-specific antigen (PSA) levels. Failure-free survival (FFS) was defined as no progression to radical treatment or nodal/distant disease. Local recurrence was defined as any International Society of Urological Pathology Grade of ≥2 on biopsy. RESULTS A total of 229 patients were analysed with a median (interquartile range [IQR]) follow-up of 60 (40-80) months. The median (IQR) age was 68 (64-74) years, the median (IQR) PSA level was 5.9 (4.1-8.2) ng/mL, and 86% harboured intermediate-risk disease and 7% high-risk disease. In all, 38 patients progressed to radical treatment (17%), at a median (IQR) of 35 (17-53) months after IRE. Kaplan-Meier FFS rates were 91% at 3 years, 84% at 5 years and 69% at 8 years. Metastasis-free survival was 99.6% (228/229), PCa-specific and overall survival were 100% (229/229). Residual csPCa was found in 24% (45/190) during follow-up biopsy and MRI showed a complete ablation in 82% (186/226). Short-term urinary continence was preserved (98%, three of 144 at baseline, 99%, one of 131 at 12 months) and erections sufficient for intercourse decreased by 13% compared to baseline (71% to 58%). CONCLUSION Longer-term follow-up confirms our earlier findings that focal IRE provides acceptable local and distant oncological control in selected men with less urinary and sexual toxicity than radical treatment. Long-term follow-up and external validation of these findings, is required to establish this new treatment paradigm as a valid treatment option.
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Affiliation(s)
- Matthijs J Scheltema
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
| | - Bart Geboers
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
| | - Alexandar Blazevski
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Paul Doan
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Athos Katelaris
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
| | - Shikha Agrawal
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
| | - Daniela Barreto
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia
| | | | | | - James E Thompson
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Phillip D Stricker
- Garvan Institute of Medical Research and The Kinghorn Cancer Centre, Darlinghurst, Sydney, NSW, Australia.,Department of Urology, St. Vincent's Prostate Cancer Research Centre, Darlinghurst, Sydney, NSW, Australia.,St. Vincent's Clinical School, University of New South Wales, Sydney, NSW, Australia
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Nassiri N, Richardson S, Kuppermann D, Brisbane WG, Gonzalez S, Kwan L, Felker E, Wallner C, Marks LS. Partial Gland Ablation of Prostate Cancer: Effects of Repeat Treatment. Urology 2022; 170:161-167. [PMID: 35907484 DOI: 10.1016/j.urology.2022.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 06/24/2022] [Accepted: 07/17/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To evaluate the near-term clinical and pathological effects of repeat partial gland ablation (PGA) in men with intermediate-risk prostate cancer (PCa). MATERIALS AND METHODS One hundred seventy men with focal lesions of PCa (all GG2 or GG3) underwent PGA with high-intensity focused ultrasound (HIFU) or cryotherapy (CRYO) in prospective trials. Residual PCa in or near the ablation zone was found in 37 men after a first PGA; 30 went on to receive a second PGA and were the subjects of study. At 3 timepoints, baseline and 6 months after first and second ablations, quality-of-life (QOL) questionnaires (IIEF, IPSS) and MRI-guided biopsies (MRGB) were performed. Biopsies were targeted and systematic at baseline and in follow-up, comprehensively about the ablation zone. RESULTS All 30 patients completed QOL questionnaires and 26 had MRGB at the 3 timepoints. Mean QOL scores were not significantly different from the baseline after the first or second PGA. No operative complications were encountered; and "decisional regret" was reported in only 2/29 men after the repeat ablation. A decrease in semen volume was reported by 25% of patients. Repeat ablation was successful (absence of csPCa on MRGB) in 14/26 (53%) of men. PSA levels decreased and MRI lesions resolved after ablations, but neither was a reliable predictor of biopsy outcomes. CONCLUSION When initial PGA fails, repeat PGA is a reasonable consideration, because in near-term follow-up, secondary procedures appear to be safe, causing only minimal detriment to urinary and sexual function, with csPCa becoming undetectable by MRGB in approximately half the patients.
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Affiliation(s)
- Nima Nassiri
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Shannon Richardson
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - David Kuppermann
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Wayne G Brisbane
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Samantha Gonzalez
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Lorna Kwan
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Ely Felker
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Caroline Wallner
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Leonard S Marks
- Department of Urology, David Geffen School of Medicine at UCLA, Los Angeles, CA.
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Rajwa P, Maggi M, Puche-Sanz I, Rempega G, Shariat SF, Zattoni F. Comment on: "Molecular biomarkers in the context of focal therapy for prostate cancer: recommendations of a Delphi Consensus from the Focal Therapy Society". Minerva Urol Nephrol 2022; 74:816-818. [PMID: 36629815 DOI: 10.23736/s2724-6051.22.05182-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Pawel Rajwa
- Department of Urology, Medical University of Vienna, Vienna, Austria - .,Department of Urology, Medical University of Silesia, Zabrze, Poland -
| | - Martina Maggi
- Department of Maternal-Infant and Urological Sciences, Sapienza University, Policlinico Umberto I Hospital, Rome, Italy
| | - Ignacio Puche-Sanz
- Department of Urology, Instituto de Investigación Biosanitaria ibs.Granada, Hospital Universitario Virgen de las Nieves (HUVN), Granada, Spain
| | - Grzegorz Rempega
- Department of Urology, Medical University of Silesia, Zabrze, Poland
| | - Shahrokh F Shariat
- Department of Urology, Medical University of Vienna, Vienna, Austria.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA
| | - Fabio Zattoni
- Unit of Urology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
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Anttinen M, Blanco Sequeiros R, Boström PJ, Taimen P. Evolving imaging methods of prostate cancer and the emergence of magnetic resonance imaging guided ablation techniques. Front Oncol 2022; 12:1043688. [DOI: 10.3389/fonc.2022.1043688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/21/2022] [Indexed: 11/18/2022] Open
Abstract
Established therapies for prostate cancer (PCa), surgery and radiotherapy, treat the entire gland regardless of the location of the cancerous lesion within the prostate. Although effective, these methods include a significant risk of worsening genitourinary outcomes. Targeted image-guided cancer therapy has gained acceptance through improved PCa detection, localization, and characterization by magnetic resonance imaging (MRI). Minimally-invasive ablative techniques aim to achieve comparable oncological outcomes to radical treatment while preserving genitourinary function. Transurethral ultrasound ablation (TULSA) and next-generation transrectal high-intensity focused ultrasound (HIFU) utilize MRI guidance to thermally ablate prostate tissue under real-time MRI monitoring and active temperature feedback control. Previous trials performed by our group and others, including a large multicenter study in men with localized favorable-risk disease, have demonstrated that TULSA provides effective prostate ablation with a favorable safety profile and low impact on quality of life. Recently, MRI-guided HIFU focal therapy was also shown as a safe and effective treatment of intermediate-risk PCa. Here we review the current literature on ablative techniques in the treatment of localized PCa with a focus on TULSA and HIFU methods.
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57
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Westhoff N, Ernst R, Kowalewski KF, Derigs F, Neuberger M, Nörenberg D, Popovic ZV, Ritter M, Stephan Michel M, von Hardenberg J. Medium-term Oncological Efficacy and Patient-reported Outcomes After Focal High-intensity Focused Ultrasound: The FOXPRO Trial. Eur Urol Focus 2022; 9:283-290. [PMID: 36344395 DOI: 10.1016/j.euf.2022.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/12/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Multiparametric magnetic resonance imaging (mpMRI)/transrectal ultrasound (TRUS) fusion-guided high-intensity focused ultrasound (HIFU) is a focal treatment option for MRI-visible localized prostate cancer (PCa). High-quality evidence regarding the clinical efficacy remains limited. OBJECTIVE To assess medium-term oncological efficacy along with patient-reported outcome measures (PROMs). DESIGN, SETTING, AND PARTICIPANTS This prospective single-center cohort study was performed from 2014 to 2020. Patients with primary International Society of Urological Pathologists (ISUP) grade group (GG) ≤2 by combined MRI/TRUS fusion and systematic prostate biopsy and prostate-specific antigen (PSA) <10 ng/ml were included. INTERVENTION MRI/TRUS fusion-guided focal HIFU therapy. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS The primary outcome was the cancer-free rate of the HIFU-treated lesion by biopsy after 1 yr. Secondary endpoints included salvage treatment-free survival (STFS), metastasis-free survival (MFS), overall survival (OS), and PROMs according to International Consortium for Health Outcomes Measurement recommendations. RESULTS AND LIMITATIONS Fifty patients were included (median [range] age 68 [48-80] yr; median PSA 6.5 [1.2-9.9] ng/ml; GG 1 54% [n = 27], and GG 2 46% [n = 23]). The median (range) PSA decrease from baseline to 12 mo was 51% (35.9-72.7%). In total, 37/50 patients (74%) underwent a 1-yr biopsy. PCa was detected in 23 patients (46%; GG 1 20% [n = 10]; GG >1 26% [n = 13]; infield 40% [n = 20]). At a median follow-up of 42 (13-73) mo, PCa was detected in 30 men (60%). Among all patients, 19 (38%) underwent salvage treatments (median [95% confidence interval] STFS 53 [44.3-61.7] mo). MFS and OS were 100% and 98%, respectively. The Expanded Prostate Cancer Index Composite-26 sexual domain decreased by 20.8 points (p = 0.372). CONCLUSIONS MRI/TRUS-guided focal HIFU therapy results in complete cancer ablation in only half of the treated patients after 1 yr, with further recurrences at medium-term follow-up. A decline of potency occurs in a subset of patients. PATIENT SUMMARY Focal image-guided high-intensity focused ultrasound therapy controls cancer in one of two patients. Its impact on urinary continence and erectile function is low.
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58
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French AFU Cancer Committee Guidelines - Update 2022-2024: prostate cancer - Diagnosis and management of localised disease. Prog Urol 2022; 32:1275-1372. [DOI: 10.1016/j.purol.2022.07.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
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A Novel PSMA-Targeted Probe for NIRF-Guided Surgery and Photodynamic Therapy: Synthesis and Preclinical Validation. Int J Mol Sci 2022; 23:ijms232112878. [PMID: 36361667 PMCID: PMC9657290 DOI: 10.3390/ijms232112878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/10/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022] Open
Abstract
A total of 20% to 50% of prostate cancer (PCa) patients leave the surgery room with positive tumour margins. The intraoperative combination of fluorescence guided surgery (FGS) and photodynamic therapy (PDT) may be very helpful for improving tumour margin delineation and cancer therapy. PSMA is a transmembrane protein overexpressed in 90−100% of PCa cells. The goal of this work is the development of a PSMA-targeted Near InfraRed Fluorescent probe to offer the surgeon a valuable intraoperative tool for allowing a complete tumour removal, implemented with the possibility of using PDT to kill the eventual not resected cancer cells. PSMA-617 binding motif was conjugated to IRDye700DX-NHS and the conjugation did not affect the photophysical characteristics of the fluorophore. The affinity of IRDye700DX-PSMA-617 towards PCa cells followed the order of their PSMA expression, i.e., PC3-PIP > LNCaP > PC3, PC3-FLU. NIRF imaging showed a significant PC3-PIP tumour uptake after the injection of 1 or 5 nmol with a maximum tumour-to-muscle ratio (ca. 60) observed for both doses 24 h post-injection. Importantly, urine, healthy prostate, and the bladder were not fluorescent at 24 h post-injection. Flow cytometry and confocal images highlighted a co-localization of PSMA+ cells with IRDye700DX-PSMA uptake. Very interestingly, ex vivo analysis on a tumour specimen highlighted a significant PSMA expression by tumour-associated macrophages, likely attributable to extracellular vesicles secreted by the PSMA(+) tumour cells. FGS proved that IRDye700DX-PSMA was able to easily delineate tumour margins. PDT experiments showed a concentration-dependent decrease in cell viability (from 75% at 10 nM to 12% at 500 nM), whereas controls did not show any cytotoxicity. PC3-PIP tumour-bearing mice subjected to photodynamic therapy showed a delayed tumour growth. In conclusion, a novel PSMA-targeted NIRF dye with dual imaging-PDT capabilities was synthesized and displayed superior specificity compared to other small PSMA targeted molecules.
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60
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Focal Therapy for Prostate Cancer: The Impact on Sexual Function. URO 2022. [DOI: 10.3390/uro2040025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Focal therapy (FT) has emerged as a potential treatment for localized prostate cancer (PCa) with encouraging functional outcomes. According to the compelling evidence based on meta-analyses and recent trials, erectile function (EF) is mostly retained at 6 and 12 months after FT when compared to baseline. These findings are consistent across different energy sources reported to date. However, overall, quality of life, including impotence, was not the endpoint for most studies. Additionally, impotency has not been consistently reported in most of the recent literature. Furthermore, confounding factors such as baseline potency and usage of phosphodiesterase 5 inhibitors (PDE5-I) were also frequently undisclosed. Long-term functional outcomes are awaited. To fully comprehend how FT affects EF, more extensive long-term randomized clinical trials using EF as a primary outcome are needed.
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61
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Rectourethral fistula following focal irreversible electroporation for prostate cancer. BMJ Case Rep 2022. [DOI: 10.1136/bcr-2022-249816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A man in his 50s presented 4-week postirreversible electroporation (IRE) for low-to-intermediate risk prostate cancer with urinary symptoms, diarrhoea and passing fluid per rectum when urinating. Urine microscopy and sensitivities showed raised leucocytes, erythrocytes and pansensitive Escherichia coli. A CT cystogram revealed a rectourethral fistula (RUF). Urinary diversion with insertion of an indwelling catheter for 6 weeks was performed. A rigid cystoscopy 6 weeks after urinary diversion revealed that the fistula was still present, confirmed by intraoperative contrast. The fistula was repaired with diathermy and a fibrin glue. The patient reported resolution of urinary and bowel symptoms. This is the first case report in the literature of an RUF following IRE for prostate cancer. It is important to report these rare complications as novel treatments become more common across the world.Background
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62
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Thomas CD, Lupu M, Poyer F, Maillard P, Mispelter J. Increased PDT Efficacy When Associated with Nitroglycerin: A Study on Retinoblastoma Xenografted on Mice. Pharmaceuticals (Basel) 2022; 15:ph15080985. [PMID: 36015132 PMCID: PMC9415823 DOI: 10.3390/ph15080985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/16/2022] Open
Abstract
Purposes: The aim of the study was to assess the efficacy of a treatment protocol that combines photodynamic therapy (PDT) and nitroglycerin (NG) on human retinoblastoma tumors xenografted on mice. We aimed to increase the PDT efficiency (in our least treatment-responsive retinoblastoma line) with better PS delivery to the tumor generated by NG, which is known to dilate vessels and enhance the permeability and retention of macromolecules in solid tumors. Methods: In vivo follow-up of the therapeutic effects was performed by sodium MRI, which directly monitors variations in sodium concentrations non-invasively and can be used to track the tumor response to therapy. NG ointment was applied one hour before PDT. The PDT protocol involves double-tumor targeting, i.e., cellular and vascular. The first PS dose was injected followed by a second one, separated by a 3 h interval. The timelapse allowed the PS molecules to penetrate tumor cells. Ten minutes after the second dose, the PS was red-light-activated. Results: In this study, we observed that the PDT effect was enhanced by applying nitroglycerin ointment to the tumor-bearing animal’s skin. PDT initiates the bystander effect on retinoblastomas, and NG increases this effect by increasing the intratumoral concentration of PS, which induces a higher production of ROS in the illuminated region and thus increases the propagation of the cell death signal deeper into the tumor (bystander effect).
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Affiliation(s)
- Carole D. Thomas
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- U1288 INSERM, LITO Laboratoire d’Imagerie Translationnelle en Oncologie, Bât. 101B, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- Correspondence: ; Tel.: +33-(0)1-69-86-71-97
| | - Mihaela Lupu
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
| | - Florent Poyer
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
| | - Philippe Maillard
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
| | - Joël Mispelter
- Institut Curie, Bât. 112, Centre Universitaire, 91405 Orsay, France
- Université Paris-Sud, 91405 Orsay, France
- U1196 INSERM, Bât. 112, Centre Universitaire, 91405 Orsay, France
- UMR 9187 CNRS, Bât. 112, Centre Universitaire, 91405 Orsay, France
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Monaco A, Sommer J, Okpara C, Lischalk JW, Haas J, Corcoran A, Katz A. Comparative results of focal-cryoablation and stereotactic body radiotherapy in the treatment of unilateral, low-to-intermediate-risk prostate cancer. Int Urol Nephrol 2022; 54:2529-2535. [PMID: 35864430 DOI: 10.1007/s11255-022-03306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 07/11/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study is to compare oncologic and functional outcomes of men with unilateral, localized PCa treated with stereotactic body radiotherapy (SBRT) versus focal cryoablation (FC). METHODS Patients from our IRB-approved PCa database who underwent FC or SBRT and were eligible for both treatments were included. Patients with less than 1 year of follow-up or prior PCa treatment were excluded. The primary outcome was treatment failure, defined as salvage treatment or a Gleason group (GG) of ≥ 2 on post-treatment biopsy. Biochemical recurrence (BCR) was evaluated with Phoenix. Functional outcomes were based on EPIC surveys. Complications were categorized with the CTCAE 5.0. Outcomes were compared using descriptive statistics, univariate analyses, and Kaplan-Meier curve for failure-free survival (FFS) and BCR-free survival. P < 0.05 was significant. RESULTS 68 FC and 51 SBRT patients with a median age of 68 years (48-86) and a median follow-up time of 84 (70-101) months were included in this analysis. There was no difference in tumor risk (p = 0.47), GG (p = 0.20), or PSA (p = 0.70) among the two cohorts at baseline. At 7-year follow-up, no difference in FFS was found between the two cohorts (p = 0.70); however, significantly more FC patients had BCR (p < 0.001). At 48 months, no differences existed in urinary or bowel function; however, SBRT patients had significantly worse sexual function (p = 0.032). CONCLUSION FC and SBRT are associated with similar oncologic and functional outcomes 7-year post-treatment. These results underscore the utility of FC and SBRT for the management of unilateral low-to-intermediate-risk PCa.
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Affiliation(s)
- Ashley Monaco
- New York Institute of Technology College of Osteopathic Medicine, 101 Northern Boulevard, Old Westbury, NY, 11568, USA.
| | - Jessica Sommer
- Department of Urology, New York University Langone, Hospital-Long Island, 1300 Franklin Ave, Mineola, NY, 11530, USA
| | - Chinyere Okpara
- Biostatistics Core, Division of Health Services Research, New York University Langone, Hospital-Long Island, 259 1st St, Mineola, NY, 11501, USA
| | - Jonathan W Lischalk
- Department of Radiation Oncology, New York University Langone, Hospital-Long Island, 259 1st St., Mineola, NY, 11501, USA
| | - Jonathan Haas
- Department of Radiation Oncology, New York University Langone, Hospital-Long Island, 259 1st St., Mineola, NY, 11501, USA
| | - Anthony Corcoran
- Department of Urology, New York University Langone, Hospital-Long Island, 1300 Franklin Ave, Mineola, NY, 11530, USA
| | - Aaron Katz
- Department of Urology, New York University Langone, Hospital-Long Island, 1300 Franklin Ave, Mineola, NY, 11530, USA
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Grauer R, Gorin MA, Sood A, Butaney M, Olson P, Farah G, Hanna Cole R, Jeong W, Abdollah F, Menon M. Impact of prostate biopsy technique on outcomes of the precision prostatectomy procedure. BMJ SURGERY, INTERVENTIONS, & HEALTH TECHNOLOGIES 2022; 4:e000122. [PMID: 35892060 PMCID: PMC9260793 DOI: 10.1136/bmjsit-2021-000122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/08/2022] [Indexed: 11/03/2022] Open
Abstract
ObjectiveTo assess the impact of iterative changes in preoperative and postoperative biopsy techniques on the outcomes of men undergoing the precision prostatectomy procedure. Precision prostatectomy is a novel surgical treatment for prostate cancer that aims to maximally preserve erectogenic nerves via partial preservation of the prostate capsule.DesignRetrospective.SettingSingle tertiary care center.ParticipantsThis study included 120 patients who consented to undergo prostate cancer treatment with the precision prostatectomy procedure. Patients were originally enrolled in one of two separate prospective protocols studying precision prostatectomy.InterventionsPreoperatively, 60 patients were screened with transrectal (TR) biopsy and 60 were screened by transperineal (TP) biopsy. Ultimately, 117 patients underwent precision prostatectomy. Of the 43 postoperative biopsies, 19 were TR; 17 were TP with ultrasound; and 7 were TP with microultrasound (mUS).Main outcome measuresPreoperatively, we evaluated whether the transition to TP biopsy was associated with differences in postoperative treatment failure defined as a neoplasm-positive postoperative biopsy. Postoperative biopsies were compared with respect to their ability to sample the remnant tissue, specifically percentage of cores positive for prostate tissue.ResultsPreoperatively, 9/60 (15%) positive postoperative biopsies occurred in the TR group and 6/60 (10%) in the TP group; Kaplan-Meier survival estimates did not differ between groups (p=0.69 by log rank). Postoperatively, the numbers of cores positive for prostate tissue were 99/160 (62%), 63/107 (59%), and 36/39 (92%) in the TR biopsy, TP with ultrasound, and TP with mUS groups, respectively; this difference was statistically significant versus the rate in the TR and standard TP groups (p=0.0003 and 0.0002).ConclusionWe found no significant improvement in patient screening, preoperatively—though limited by small sample size and relatively short follow-up. The incorporation of high-frequency mUS for postoperative biopsies improved the ability to sample the remnant tissue with a higher efficiency.
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Affiliation(s)
- Ralph Grauer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Michael A. Gorin
- Urology, Urology Associates and UPMC Western Maryland, Cumberland, Maryland, USA
- Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Akshay Sood
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Mohit Butaney
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Phil Olson
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Guillaume Farah
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Renee Hanna Cole
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Wooju Jeong
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Firas Abdollah
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
| | - Mani Menon
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Vattikuti Urology Institute, Henry Ford Hospital, Detroit, Michigan, USA
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Fukushima H, Turkbey B, Pinto PA, Furusawa A, Choyke PL, Kobayashi H. Near-Infrared Photoimmunotherapy (NIR-PIT) in Urologic Cancers. Cancers (Basel) 2022; 14:2996. [PMID: 35740662 PMCID: PMC9221010 DOI: 10.3390/cancers14122996] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/12/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Near-infrared photoimmunotherapy (NIR-PIT) is a novel molecularly-targeted therapy that selectively kills cancer cells by systemically injecting an antibody-photoabsorber conjugate (APC) that binds to cancer cells, followed by the application of NIR light that drives photochemical transformations of the APC. APCs are synthesized by selecting a monoclonal antibody that binds to a receptor on a cancer cell and conjugating it to IRDye700DX silica-phthalocyanine dye. Approximately 24 h after APC administration, NIR light is delivered to the tumor, resulting in nearly-immediate necrotic cell death of cancer cells while causing no harm to normal tissues. In addition, NIR-PIT induces a strong immunologic effect, activating anti-cancer immunity that can be further boosted when combined with either immune checkpoint inhibitors or immune suppressive cell-targeted (e.g., regulatory T cells) NIR-PIT. Currently, a global phase III study of NIR-PIT in recurrent head and neck squamous cell carcinoma is ongoing. The first APC and NIR laser systems were approved for clinical use in September 2020 in Japan. In the near future, the clinical applications of NIR-PIT will expand to other cancers, including urologic cancers. In this review, we provide an overview of NIR-PIT and its possible applications in urologic cancers.
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Affiliation(s)
- Hiroshi Fukushima
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Baris Turkbey
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Peter A. Pinto
- Urologic Oncology Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA;
| | - Aki Furusawa
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Peter L. Choyke
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
| | - Hisataka Kobayashi
- Molecular Imaging Branch, Center for Cancer Research, National Cancer Institute (NIH), Bethesda, MD 20892, USA; (H.F.); (B.T.); (A.F.); (P.L.C.)
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Alternative- and focal therapy trends for prostate cancer: a total population analysis of in-patient treatments in Germany from 2006 to 2019. World J Urol 2022; 40:1645-1652. [PMID: 35562598 PMCID: PMC9236973 DOI: 10.1007/s00345-022-04024-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/22/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose Focal therapy (FT) offers an alternative approach for prostate cancer (PCa) treatment in selected patients. However, little is known on its actual establishment in health care reality. Patients and methods We defined FT as high-intensity focused ultrasound (HIFU), hyperthermia ablation, cryotherapy, transurethral ultrasound ablation (TULSA) or vascular-targeted photodynamic therapy (VTP) TOOKAD®. We analyzed the nationwide German hospital billing database for a PCa diagnosis in combination with FT. For analyses on the hospital level, we used the reimbursement.INFO tool based on hospitals’ quality reports. The study period was 2006 to 2019. Results We identified 23,677 cases of FT from 2006 to 2019. Considering all PCa cases with surgery, radiotherapy or FT, the share of FT was stable at 4%. The annual caseload of FT increased to a maximum of 2653 cases in 2008 (p < 0.001) and then decreased to 1182 cases in 2014 (p < 0.001). Since 2015, the cases of FT remained on a plateau around 1400 cases per year. The share of HIFU was stable at 92–96% from 2006 to 2017 and decreased thereafter to 75% in 2019 (p = 0.015). In 2019, VTP-TOOKAD® increased to 11.5% and TULSA to 6%. In 2006, 21% (62/299) of urological departments performed FT and 20 departments reached > 20 FT procedures. In 2019, 16% (58/368) of urological departments performed FT and 7 departments reached > 20 FT. In 2019, 25 urological departments offered FT other than HIFU: 5 centers hyperthermia ablation, 11 centers VTP TOOKAD®, 3 centers cryotherapy, 6 centers TULSA. Conclusion The FT development in Germany followed the Gartner hype cycle. While HIFU treatment is the most commonly performed FT, the share of newer FT modalities such as VTP-TOOKAD® and TULSA is remarkably increasing. Supplementary Information The online version contains supplementary material available at 10.1007/s00345-022-04024-0.
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Clark R, Klotz L. Focal therapy: definition and rationale. Curr Opin Urol 2022; 32:218-223. [PMID: 35220365 DOI: 10.1097/mou.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The role of focal therapy for the treatment of prostate cancer is expanding in clinical practice. The aim of this review is to introduce readers to controversies in the use of focal therapy and its rationale. RECENT FINDINGS There is a growing body of literature regarding the short-term and medium-term cancer control parameters and quality of life outcomes. These are mostly observational studies without a comparative arm. There is a need for high-quality randomize control trials comparing these treatments to definitive standard of care interventions (e.g. surgery or radiotherapy) in appropriate patient populations. SUMMARY Focal therapy for prostate cancer has become an established therapeutic strategy. Evidence continues to accrue regarding its effectiveness. It is a useful treatment option for the appropriately selected patient, with the appeal of improved quality of life compared with standard therapies.
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Affiliation(s)
| | - Laurence Klotz
- Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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Jaipuria J, Ahmed HU. Clinical and pathologic characteristics to select patients for focal therapy or partial gland ablation of nonmetastatic prostate cancer. Curr Opin Urol 2022; 32:224-230. [PMID: 35184067 DOI: 10.1097/mou.0000000000000976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE OF REVIEW Focal therapy or partial gland ablation for nonmetastatic prostate cancer is gaining popularity not just as an alternative to active surveillance, but as an acceptable alternative to whole gland therapy in appropriate cases. This review summarizes recent evidence to help select patients for optimal outcomes. RECENT FINDINGS Recommendations by expert panels have become less conservative with each meeting. As experience with older modalities for focal therapy grows, newer modalities continue to be introduced. We are now in a position to offer personalized treatment pathway considering nuances of each focal therapy modality. SUMMARY The ideal case for focal therapy should be an MRI visible significant lesion (PIRADS score ≥ 3), with a positive biopsy for significant cancer (Gleason grade group 2-3) in the corresponding targeted biopsy area, and insignificant or absent disease in the nontarget random biopsy areas. Multifocal disease can also be selectively treated. Salvage focal ablation is an attractive treatment option for radio-recurrent or index focal therapy failure cases.
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Affiliation(s)
- Jiten Jaipuria
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust
| | - Hashim U Ahmed
- Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust
- Imperial Prostate, Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK
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Montorsi F, Stabile A, Gandaglia G, Briganti A. Re: Jana S. Hopstaken, Joyce G.R. Bomers, Michiel J.P. Sedelaar, et al. An Updated Systematic Review on Focal Therapy in Localized Prostate Cancer: What Has Changed over the Past 5 Years? Eur Urol 2022;81:5–33. Eur Urol 2022; 81:e122. [DOI: 10.1016/j.eururo.2022.01.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Accepted: 01/19/2022] [Indexed: 11/04/2022]
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Avital Y, Fütterer JJ, Cherniavsky A, Bomers JGR. Minimally Invasive Procedures in the Diagnosis and Treatment of Localized Prostate Cancer: an Interventional Radiologist's Perspective. Curr Oncol Rep 2022; 24:1433-1441. [PMID: 35670993 PMCID: PMC9606051 DOI: 10.1007/s11912-022-01291-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2022] [Indexed: 01/27/2023]
Abstract
PURPOSE OF REVIEW Minimal invasive procedures, including targeted biopsy (TB) and focal therapy (FT), are increasingly used in diagnosis and treatment of localized prostate cancer. Here, we review the current role of these procedures, from a perspective of an interventional radiologist. RECENT FINDINGS TB is an established part of current guidelines for diagnosis of PCa. Several modalities of FT are gaining prevalence in recent years, as a tissue-preserving alternative for definitive treatment of localized PCa. FT is currently at early research stages, offered to selected patients in clinical trials settings. TB and FT are minimally invasive procedures used by multidisciplinary teams for diagnosis and treatment of localized PCa.
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Affiliation(s)
- Yaniv Avital
- Department of Medical Imaging, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, Gelderland The Netherlands ,Department of Interventional Radiology, Shamir Medical Center (Assaf Harofeh), 70300 Zerifin, Israel
| | - Jurgen J. Fütterer
- Department of Medical Imaging, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, Gelderland The Netherlands
| | - Alexei Cherniavsky
- Department of Interventional Radiology, Shamir Medical Center (Assaf Harofeh), 70300 Zerifin, Israel
| | - Joyce G. R. Bomers
- Department of Medical Imaging, Radboud University Nijmegen Medical Centre, Geert Grooteplein 10, 6525 GA Nijmegen, Gelderland The Netherlands
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Nguyen AT, Kamrava M. Re: Jana S. Hopstaken, Joyce G.R. Bomers, Michiel J.P. Sedelaar, Massimo Valerio, Jurgen J. Fütterer, Maroeska M. Rovers. An Updated Systematic Review on Focal Therapy in Localized Prostate Cancer: What Has Changed over the Past 5 Years? Eur Urol. In press. https://doi.org/ 10.1016/j.eururo.2021.08.005. Eur Urol 2021; 81:e48-e49. [PMID: 34848080 DOI: 10.1016/j.eururo.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/01/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Anthony T Nguyen
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Mitchell Kamrava
- Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
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Abreu AL, Kaneko M, Cacciamani GE, Lebastchi AH. Focal Therapy for Prostate Cancer: Getting Ready for Prime Time. Eur Urol 2021; 81:34-36. [PMID: 34740501 DOI: 10.1016/j.eururo.2021.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/06/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Andre Luis Abreu
- USC Institute of Urology, Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Masatomo Kaneko
- USC Institute of Urology, Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Giovanni E Cacciamani
- USC Institute of Urology, Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Amir H Lebastchi
- USC Institute of Urology, Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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