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      Available evidence on HIFU for focal treatment of prostate cancer: a systematic review

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          ABSTRACT

          Purpose:

          Prostate cancer (PCa) is the second most common oncologic disease among men. Radical treatment with curative intent provides good oncological results for PCa survivors, although definitive therapy is associated with significant number of serious side-effects. In modern-era of medicine tissue-sparing techniques, such as focal HIFU, have been proposed for PCa patients in order to provide cancer control equivalent to the standard-of-care procedures while reducing morbidities and complications. The aim of this systematic review was to summarise the available evidence about focal HIFU therapy as a primary treatment for localized PCa.

          Material and methods:

          We conducted a comprehensive literature review of focal HIFU therapy in the MEDLINE database (PROSPERO: CRD42021235581). Articles published in the English language between 2010 and 2020 with more than 50 patients were included.

          Results:

          Clinically significant in-field recurrence and out-of-field progression were detected to 22% and 29% PCa patients, respectively. Higher ISUP grade group, more positive cores at biopsy and bilateral disease were identified as the main risk factors for disease recurrence. The most common strategy for recurrence management was definitive therapy. Six months after focal HIFU therapy 98% of patients were totally continent and 80% of patients retained sufficient erections for sexual intercourse. The majority of complications presented in the early postoperative period and were classified as low-grade.

          Conclusions:

          This review highlights that focal HIFU therapy appears to be a safe procedure, while short-term cancer control rate is encouraging. Though, second-line treatment or active surveillance seems to be necessary in a significant number of patients.

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          Most cited references46

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation

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              Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation.

              Protocols of systematic reviews and meta-analyses allow for planning and documentation of review methods, act as a guard against arbitrary decision making during review conduct, enable readers to assess for the presence of selective reporting against completed reviews, and, when made publicly available, reduce duplication of efforts and potentially prompt collaboration. Evidence documenting the existence of selective reporting and excessive duplication of reviews on the same or similar topics is accumulating and many calls have been made in support of the documentation and public availability of review protocols. Several efforts have emerged in recent years to rectify these problems, including development of an international register for prospective reviews (PROSPERO) and launch of the first open access journal dedicated to the exclusive publication of systematic review products, including protocols (BioMed Central's Systematic Reviews). Furthering these efforts and building on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, an international group of experts has created a guideline to improve the transparency, accuracy, completeness, and frequency of documented systematic review and meta-analysis protocols--PRISMA-P (for protocols) 2015. The PRISMA-P checklist contains 17 items considered to be essential and minimum components of a systematic review or meta-analysis protocol.This PRISMA-P 2015 Explanation and Elaboration paper provides readers with a full understanding of and evidence about the necessity of each item as well as a model example from an existing published protocol. This paper should be read together with the PRISMA-P 2015 statement. Systematic review authors and assessors are strongly encouraged to make use of PRISMA-P when drafting and appraising review protocols. © BMJ Publishing Group Ltd 2014.
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                Author and article information

                Journal
                Int Braz J Urol
                Int Braz J Urol
                ibju
                International Brazilian Journal of Urology : Official Journal of the Brazilian Society of Urology
                Sociedade Brasileira de Urologia
                1677-5538
                1677-6119
                20 April 2021
                Mar-Apr 2022
                : 48
                : 2
                : 263-274
                Affiliations
                [1 ] orgnameVilnius University orgdiv1Faculty of Medicine Vilnius Lithuania originalFaculty of Medicine, Vilnius University, Vilnius, Lithuania
                [2 ] orgnameInstitut Mutualiste Montsouris orgdiv1Department of Urology Paris France originalDepartment of Urology, Institut Mutualiste Montsouris, Paris, France
                [3 ] orgnameDuke University orgdiv1Department of Urology Durham NC USA originalDepartment of Urology, Duke University, Durham, NC, USA
                [4 ] orgnameKeck School of Medicine and University of South California orgdiv1Department of Urology CA USA originalDepartment of Urology, Keck School of Medicine and University of South California, CA, USA
                [5 ] orgnameUniversity of Michigan orgdiv1Department of Urology Ann Arbor MI USA originalDepartment of Urology, University of Michigan, Ann Arbor, MI, USA
                [6 ] orgnameInstitut Universitaire du Cancer Toulouse Oncopole orgdiv1Department of Urology Toulouse France originalDepartment of Urology, Institut Universitaire du Cancer Toulouse Oncopole, Toulouse, France
                [7 ] orgnameCentre Hospitalier René-Dubos orgdiv1Department of Urology Pontoise France originalDepartment of Urology, Centre Hospitalier René-Dubos (Pontoise), France
                [8 ] orgnameVita-Salute San Raffaele University orgdiv1IRCCS San Raffaele Scientific Institute orgdiv2Department of Urology and Division of Experimental Oncology Milan Italy originalDepartment of Urology and Division of Experimental Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
                [9 ] orgnameLucerne Kanton Hospital orgdiv1Department of Urology Lucerne Switzerland originalDepartment of Urology, Lucerne Kanton Hospital, Lucerne, Switzerland
                [10 ] orgnameLenox Hill Urology orgdiv1Department of Urology NY USA originalDepartment of Urology, Lenox Hill Urology, NY, USA
                [11 ] orgnameUniversity of Cincinnati College of Medicine orgdiv1Division of Urology Cincinnati OH USA originalDivision of Urology, University of Cincinnati College of Medicine, Cincinnati, OH, USA
                [12 ] orgnameFaculdade de Medicina do ABC orgdiv1Departamento de Urologia São Paulo Brasil originalDepartamento de Urologia, Faculdade de Medicina do ABC (Faculdade de Medicina do ABC), São Paulo, Brasil
                [13 ] orgnameIstanbul Medipol Mega University Hospital orgdiv1Department of Urology Istanbul Turkey originalDepartment of Urology, Istanbul Medipol Mega University Hospital, Istanbul, Turkey
                [14 ] orgnameImperial College London orgdiv1Faculty of Medicine orgdiv2Department of Surgery & Cancer London United Kingdom originalFaculty of Medicine, Department of Surgery & Cancer, Imperial College London, United Kingdom
                Author notes
                Correspondence address: Rafael Sanchez-Salas, MD, Department of Urology, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014, Paris, France. Fax: + 33-01-56-61-72-68. Email: rafael.sanchez-salas@ 123456imm.fr

                CONFLICT OF INTEREST

                None declared.

                Author information
                https://orcid.org/0000-0002-3766-5642
                Article
                S1677-5538.IBJU.2021.0091
                10.1590/S1677-5538.IBJU.2021.0091
                8932027
                34003610
                04283757-9519-4ad1-aa49-8cf8707f9288

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 February 2021
                : 18 February 2021
                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 39, Pages: 12
                Categories
                Review Article

                prostate cancer, familial [supplementary concept],high-intensity focused ultrasound ablation,technology,complications [subheading]

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