{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:33:34Z","timestamp":1791232414886,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,4,3]],"date-time":"2017-04-03T00:00:00Z","timestamp":1491177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2017,8]]},"abstract":"\n Objective<\/jats:title>\n \n To assess short\u2010 to medium\u2010term cancer control rates and side effects of focal salvage high\u2010 intensity focused ultrasound (\n HIFU<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n A retrospective registry analysis identified 150 men who underwent focal salvage HIFU (FS\u2010HIFU) (Sonablate 500) between November 2006 and August 2015. Metastatic disease was excluded by nodal assessment on the pelvic\n MRI<\/jats:styled-content>\n , a radioisotope bone scan and positron\u2010emission tomography (\n PET<\/jats:styled-content>\n ) imaging (choline\u201018F\u2010fluorodeoxyglucose\n PET<\/jats:styled-content>\n or choline\n PET<\/jats:styled-content>\n \u2010\n CT<\/jats:styled-content>\n ). In our current clinical practice, metastatic disease must be excluded by both choline\n PET<\/jats:styled-content>\n and bone scan. Localization of cancer was carried out using multiparametric\n MRI<\/jats:styled-content>\n of the prostate (T2\u2010weighted, diffusion\u2010weighted and dynamic contrast\u2010enhanced imaging) with systematic or template prostate mapping biopsies. The primary outcome was a composite failure incorporating biochemical failure (\n BCF<\/jats:styled-content>\n ) and\/or positive localized or distant imaging results and\/or positive biopsy and\/or systemic therapy and\/or metastases\/prostate cancer\u2010specific death. The secondary outcome was\n BCF<\/jats:styled-content>\n using the Phoenix\u2010\n ASTRO<\/jats:styled-content>\n definition (prostate\u2010specific antigen [\n PSA<\/jats:styled-content>\n ] nadir + 2\u00a0ng\/mL). We used Kaplan\u2013Meier analysis and Cox proportional hazards regression to quantify the effect of the determinants on the endpoints.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The mean (standard deviation [\n sd<\/jats:sc>\n ]) patient age at focal salvage\n HIFU<\/jats:styled-content>\n was 69.8 (6.1) years and the median (interquartile range [\n IQR<\/jats:styled-content>\n ])\n PSA<\/jats:styled-content>\n pre\u2010focal salvage\n HIFU<\/jats:styled-content>\n was 5.5 (3.6\u20137.9) ng\/\n mL<\/jats:styled-content>\n . The median (\n IQR<\/jats:styled-content>\n ) follow\u2010up was 35 (22\u201352) months. Patients were classified as having low\u2010 2.7% (4\/150), intermediate\u2010 39.3% (59\/150) and high\u2010risk disease 41.3% (62\/150) according to D'Amico classification, prior to focal salvage\n HIFU<\/jats:styled-content>\n . Composite failure occurred in 61% of patients (91\/150) and\n BCF<\/jats:styled-content>\n occurred in 51.3% (77\/150). The Kaplan\u2013Meier composite endpoint\u2010free survival (\n CEFS<\/jats:styled-content>\n ) rate at 3\u00a0years was 40% (95% confidence interval [\n CI<\/jats:styled-content>\n ] 31\u201350) for the entire group. Kaplan\u2013Meier estimates of\n CEFS<\/jats:styled-content>\n were 100%, 49% and 24% at 3\u00a0years in the low\u2010, intermediate\u2010 and high\u2010risk groups pre\u2010salvage\n HIFU<\/jats:styled-content>\n , respectively. The Kaplan\u2013Meier biochemical disease\u2010free survival (\n BDFS<\/jats:styled-content>\n ) rate at 3\u00a0years was 48% (95%\n CI<\/jats:styled-content>\n 39\u201359) for the entire group. Kaplan\u2013Meier estimates of\n BDFS<\/jats:styled-content>\n were 100%, 61% and 32% at 3\u00a0years in the low\u2010, intermediate\u2010 and high\u2010risk groups pre\u2010salvage\n HIFU<\/jats:styled-content>\n , respectively. Complications included urinary tract infection (11.3%; 17\/150), bladder neck stricture (8%; 12\/150), recto\u2010urethral fistula after one\n HIFU<\/jats:styled-content>\n procedure (2%; 3\/150) and osteitis pubis (0.7%; 1\/150).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Focal salvage\n HIFU<\/jats:styled-content>\n conferred a relatively low complication and side effect rate.\n CEFS<\/jats:styled-content>\n and biochemical control in the short to medium term were reasonable, especially in this relatively high\u2010risk cohort, but still low compared with current whole\u2010gland salvage therapies. Focal salvage therapy may offer disease control in men at high risk whilst minimizing additional treatment morbidities.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.13831","type":"journal-article","created":{"date-parts":[[2017,3,4]],"date-time":"2017-03-04T06:15:22Z","timestamp":1488608122000},"page":"246-256","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Focal salvage high\u2010intensity focused ultrasound in radiorecurrent prostate cancer"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1599-2455","authenticated-orcid":false,"given":"Abi","family":"Kanthabalan","sequence":"first","affiliation":[{"name":"Division of Surgery and Interventional Science University College London London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7981-5768","authenticated-orcid":false,"given":"Max","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Van Vulpen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Medical Centre Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"McCartan","sequence":"additional","affiliation":[{"name":"Division of Surgery and Interventional Science University College London London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard Graham","family":"Hindley","sequence":"additional","affiliation":[{"name":"Department of Urology Hampshire Hospitals NHS Foundation Trust Basingstoke UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amr","family":"Emara","sequence":"additional","affiliation":[{"name":"Department of Urology Hampshire Hospitals NHS Foundation Trust Basingstoke UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Moore","sequence":"additional","affiliation":[{"name":"Division of Surgery and Interventional Science University College London London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manit","family":"Arya","sequence":"additional","affiliation":[{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Emberton","sequence":"additional","affiliation":[{"name":"Division of Surgery and Interventional Science University College London London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hashim Uddin","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Division of Surgery and Interventional Science University College London London UK"},{"name":"Department of Urology University College London Hospitals NHS Foundation Trust London UK"},{"name":"Division of Surgery Department of Surgery and Cancer Faculty of Medicine Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,4,3]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.05.023"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2012.01.022"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.09.028"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2013.12.014"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.07.010"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-016-1811-9"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09291.x"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.12.009"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27394"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199807000-00007"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(97)00238-0"},{"key":"e_1_2_5_13_1","unstructured":"R: The R Project for Statistical Computing[Internet]. 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