{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:02:03Z","timestamp":1791910923182,"version":"4.3.4"},"reference-count":39,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T00:00:00Z","timestamp":1665532800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We aimed to conduct a systematic review and meta-analysis of studies reporting functional and oncologic outcomes of combining whole-gland high-intensity focused ultrasound ablation (HIFU) with transurethral resection of the prostate (TURP) in prostate cancer (PCa) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, Web of Science, Scopus, and Cochrane Library were systematically searched until June 30, 2022. The ROBINS-I tool scale was used to evaluate quality of eligible studies. Biochemical failure was defined according to the criteria used in each raw study. The presence of any cancer on follow-up biopsy was classified as \u201cpositive biopsy\u201d. Patients able to penetrate their partner without pharmacologic support were rated potent. Meta-analysis was performed to evaluate functional outcomes using R project.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1861 patients in 15 eligible studies were included. All studies were identified as moderate or high quality. There were 1388 (74.6%) patients with low-risk or intermediate-risk PCa in 15 studies and 473 (25.4%) patients with high-risk PCa in 12 studies. The mean PSA nadir postoperatively ranged from 0.20 to 1.90 ng\/mL within average time of 1.9-12 months. Biochemical failure rates in all 15 studies ranged from 6.3% to 34% within average time of 1.9-60 months. Eleven studies reported the rates of positive biopsy ranged from 3% to 29.7% within average time of 3-12 months postoperatively. Based on the results of single-arm meta-analysis, the pooled rates of any degree urinary incontinence, acute urinary retention, urinary tract infections, and urethral stricture were 9.4% (95% CI: 6.1%-12.6%), 0.9% (95% CI: 0%-2%), 2.6% (95% CI: 0.8%-4.3%), and 4.3% (95% CI: 1.4%-7.1%), respectively. The pooled rate of being potent after procedure in previously potent patients was 43.6% (95% CI: 27.3%-59.8%). The sensitivity analysis revealed all the pooled results was relatively reliable. Egger\u2019s tests for the pooled results of acute urinary retention (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.0651) and potency (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.6749) both did not show significant publication bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>It appears that the combination treatment of whole-gland HIFU and TURP could be applied for PCa patients. It might have potential advantages of decreasing catheterization time and improving urinary status. Prospective and comparative studies are needed to validate our findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2022.988490","type":"journal-article","created":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T04:26:21Z","timestamp":1665548781000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Whole-gland high-intensity focused ultrasound ablation and transurethral resection of the prostate in the patients with prostate cancer: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Yang","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shangren","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqiang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29538","article-title":"Prevalence of incidental prostate cancer: A systematic review of autopsy studies","volume":"137","author":"Bell","year":"2015","journal-title":"Int J Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2004.10.062","article-title":"The changing face of low-risk prostate cancer: trends in clinical presentation and primary management","volume":"22","author":"Cooperberg","year":"2004","journal-title":"J Clin Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2016.03.048","article-title":"Long-term results of active surveillance in the g\u00f6teborg randomized, population-based prostate cancer screening trial","volume":"70","author":"Godtman","year":"2016","journal-title":"Eur Urol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1606221","article-title":"Patient-reported outcomes after monitoring, surgery, or radiotherapy for prostate cancer","volume":"375","author":"Donovan","year":"2016","journal-title":"N Engl J Med"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-148-6-200803180-00209","article-title":"Systematic review: comparative effectiveness and harms of treatments for clinically localized prostate cancer","volume":"148","author":"Wilt","year":"2008","journal-title":"Ann Intern Med"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1148\/rg.2018170129","article-title":"High-intensity focused ultrasound for pain management in patients with cancer","volume":"38","author":"Dababou","year":"2018","journal-title":"Radiographics"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1007\/s00247-019-04426-0","article-title":"Magnetic-resonance-guided focused ultrasound treatment of non-spinal osteoid osteoma in children: multicentre experience","volume":"49","author":"Arrigoni","year":"2019","journal-title":"Pediatr Radiol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejrad.2019.108700","article-title":"Magnetic resonance-high intensity focused ultrasound (MR-HIFU) therapy of symptomatic uterine fibroids with unrestrictive treatment protocols: A systematic review and meta-analysis","volume":"120","author":"Verpalen","year":"2019","journal-title":"Eur J Radiol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1080\/17434440.2020.1755258","article-title":"High-intensity focused ultrasound for prostate cancer","volume":"17","author":"Napoli","year":"2020","journal-title":"Expert Rev Med Devices"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.12.076","article-title":"Factors predicting for formation of bladder outlet obstruction after high-intensity focused ultrasound in treatment of localized prostate cancer","volume":"71","author":"Blana","year":"2008","journal-title":"Urology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"S92","DOI":"10.21037\/tau.2017.04.33","article-title":"Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer","volume":"6","author":"Nicholson","year":"2017","journal-title":"Transl Androl Urol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-022-03156-x","article-title":"Long-term outcomes of whole gland high-intensity focused ultrasound for localized prostate cancer","volume":"54","author":"Lo Verde","year":"2022","journal-title":"Int Urol Nephrol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.clgc.2021.09.003","article-title":"High intensity focused ultrasound ablation for prostate cancer: Whole versus partial gland ablation","volume":"20","author":"Byun","year":"2022","journal-title":"Clin Genitourin Cancer"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2019.11.014","article-title":"High-intensity focused ultrasound for the treatment of prostate cancer: A national cohort study focusing on the development of stricture and fistulae","volume":"7","author":"Dosanjh","year":"2021","journal-title":"Eur Urol Focus"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2010.06.005","article-title":"Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement","volume":"58","author":"Ahyai","year":"2010","journal-title":"Eur Urol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-003-0077-0","article-title":"The status of high-intensity focused ultrasound in the treatment of localized prostate cancer and the impact of a combined resection","volume":"4","author":"Chaussy","year":"2003","journal-title":"Curr Urol Rep"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000124880.35944.58","article-title":"Transrectal focused ultrasound combined with transurethral resection of the prostate for the treatment of localized prostate cancer: Feasibility study","volume":"171","author":"Vallancien","year":"2004","journal-title":"J Urol"},{"key":"B18","article-title":"Transurethral resection of prostate just following high intensity focused ultrasound in localized prostate cancer -trial for early removal of the urethral catheter","volume":"54","author":"Otsuki","year":"2008","journal-title":"Acta Urologica Japonica"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2006.04.029","article-title":"Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO phoenix consensus conference","volume":"65","author":"Roach","year":"2006","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2009.08518.x","article-title":"High-intensity focused ultrasound for prostate cancer: comparative definitions of biochemical failure","volume":"104","author":"Blana","year":"2009","journal-title":"BJU Int"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: a revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"Bmj"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: a tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"Bmj"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.23750\/abm.v89i2.6730","article-title":"Recurrence of prostate cancer after HIFU. proposal of a novel predictive index","volume":"89","author":"Maestroni","year":"2018","journal-title":"Acta BioMed"},{"key":"B24","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s12894-017-0198-2","article-title":"Quality of life and functional outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer","volume":"17","author":"Hatiboglu","year":"2017","journal-title":"BMC Urol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4686-x","article-title":"Comparisons of oncological and functional outcomes between primary whole-gland cryoablation and high-intensity focused ultrasound for localized prostate cancer","volume":"23","author":"Liu","year":"2016","journal-title":"Ann Surg Oncol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.urols.2016.09.002","article-title":"Single session of high-intensity focused ultrasound therapy for the management of organ-confined prostate cancer: A single-institute experience","volume":"27","author":"Juho","year":"2016","journal-title":"Urological Sci"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.02.010","article-title":"Evolution and outcomes of 3 MHz high intensity focused ultrasound therapy for localized prostate cancer during 15 years","volume":"190","author":"Th\u00fcroff","year":"2013","journal-title":"J Urol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1348253","article-title":"High-intensity focussed ultrasound in low-risk prostate cancer - oncological outcome and postinterventional quality of life of an inexperienced therapy centre in comparison with an experienced therapy centre","volume":"44","author":"Baumunk","year":"2013","journal-title":"Aktuelle Urol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.4103\/0970-1591.85431","article-title":"Preliminary safety and efficacy results with robotic high-intensity focused ultrasound : A single center Indian experience","volume":"27","author":"Mishra","year":"2011","journal-title":"Indian J Urol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2011.02739.x","article-title":"Transrectal high-intensity focused ultrasound for treatment of localized prostate cancer","volume":"18","author":"Inoue","year":"2011","journal-title":"Int J Urol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2042.2010.02638.x","article-title":"Transurethral resection of the prostate immediately after high-intensity focused ultrasound treatment for prostate cancer","volume":"17","author":"Sumitomo","year":"2010","journal-title":"Int J Urol"},{"key":"B32","article-title":"High intensity focused ultrasound (HIFU): A useful alternative choice in prostate cancer treatment","volume":"79","author":"Maestroni","year":"2008","journal-title":"Preliminary Results Acta BioMed"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2006.04.012","article-title":"Control of prostate cancer by transrectal HIFU in 227 patients","volume":"51","author":"Poissonnier","year":"2007","journal-title":"Eur Urol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1038\/sj.pcan.4500901","article-title":"High-intensity focused ultrasound therapy for clinically localized prostate cancer","volume":"9","author":"Lee","year":"2006","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2017.11.008","article-title":"Oncological and functional outcomes of elderly men treated with HIFU vs. minimally invasive radical prostatectomy: A propensity score analysis","volume":"44","author":"Capogrosso","year":"2018","journal-title":"Eur J Surg Oncol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2020.12.016","article-title":"Oncological long-term outcome after whole-gland high-intensity focused ultrasound for prostate cancer-21-yr follow-up","volume":"8","author":"Br\u00fcndl","year":"2022","journal-title":"Eur Urol Focus"},{"key":"B37","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.prnil.2016.01.001","article-title":"Holmium laser enucleation of the prostate followed by high-intensity focused ultrasound treatment for patients with huge prostate adenoma and localized prostate cancer: 5-year follow-up","volume":"4","author":"Horiuchi","year":"2016","journal-title":"Prostate Int"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2007.10.062","article-title":"First analysis of the long-term results with transrectal HIFU in patients with localised prostate cancer","volume":"53","author":"Blana","year":"2008","journal-title":"Eur Urol"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.3109\/21681805.2014.988174","article-title":"High-intensity focused ultrasound for the treatment of prostate cancer: A prospective trial with long-term follow-up","volume":"49","author":"Mearini","year":"2015","journal-title":"Scand J Urol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.988490\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,12]],"date-time":"2022-10-12T04:26:29Z","timestamp":1665548789000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2022.988490\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,12]]},"references-count":39,"alternative-id":["10.3389\/fonc.2022.988490"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2022.988490","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,12]]},"article-number":"988490"}}