ArticleWorld journal of urology2025
Use of biochemical and imaging criteria for selecting patients for prostate biopsy in recurrence risk assessment post-HIFU therapy.
Article in World journal of urology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Pathologic failure and salvage approaches following focal therapy for localized prostate cancer.The Canadian journal of urology · 2026Article
- External validation of the cancer of the prostate risk assessment score to predict treatment failure after high-intensity focused ultrasound.Prostate international · 2026Article
- Evolution of the prostate cancer diagnostic paradigm: integrated evidence and clinical pathways from targeted biopsy to biopsy-free strategy.Frontiers in oncology · 2026Review
- Comment on: "Robotic versus open surgery for ureteroenteric stricture after radical cystectomy: a systematic review and meta‑analysis".Journal of robotic surgery · 2025Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDespite the growing adoption of HIFU treatment for localized prostate cancer (PC), standardized criteria for evaluating success and predicting recurrence remain undefined. Herein, we analyze the predictive value of noninvasive tools such as PSA dynamics and MRI to determine recurrence.
methodsWe identified from our HIFU therapy prospective registry patients who developed biopsy-proven recurrence, between 2016 and 2023. Clinically significant recurrence (CS-R) was defined as the presence of GG 2 or greater on control biopsy. Different modalities of PSA kinetics were analyzed and determinants for recurrence were based on either PSA or MRI criteria (PIRADS > 3). Sensitivity, specificity, PPV, and NPV were estimated based on single or combined criteria.
results92 patients were included in the study. A total of 17(18%) patients had CS-R. Those patients presented higher PSA velocity (p < 0.001) and a higher proportion of PSA above nadir + 1 at 12 months (p = 0.001). Static PSA measurement and % of PSA drop were not associated with recurrence. Follow-up based on a combination of PSA parameters (PSA below nadir + 1) and MRI criteria had higher sensitivity (88%) and negative predictive value (96%) in detecting post-treatment recurrence. Limitation of the study included limited number of patients and a relatively short follow up period.
conclusionsPost-HIFU recurrence surveillance through dynamic PSA monitoring shows better predictive value. Implementing 'for cause' surveillance biopsies guided by dynamic PSA changes along with mpMRI appears to enhance the detection of recurrences without missing a significant number of cases.
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