ArticleWorld journal of urology2026
Hemigland cryoablation versus high-intensity focused ultrasound for localized prostate cancer: a propensity-weighted comparison of functional and oncologic outcomes.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWhether cryoablation and high-intensity focused ultrasound (HIFU) provide distinct advantages in hemigland ablation for localized prostate cancer (PCa) is unresolved.
methodsA prospective FT-PCa registry (2021–2025) was analysed, identifying 258 men treated with hemigland ablation (cryoablation n = 179; HIFU n = 79). Baseline differences were addressed through inverse-probability-of-treatment weighting based on age, PSA, PSA density, ISUP, PI-RADS, lesion size, % of positive cores and prostate volume. Weighted Kaplan–Meier estimators, log-rank tests and Cox models were used for time-to-event outcomes; perioperative and functional variables were compared using design-based t-tests and Rao–Scott χ² tests. Primary endpoints were failure-free survival (FFS) and biochemical failure-free survival (BFS). A subgroup analysis excluding low-risk disease was additionally performed.
resultsWeighting achieved excellent covariate balance (all standardized mean differences < 0.10). Perioperative outcomes were similar, including operative time (p = 0.41) and complications (p = 0.49). At 12 months, continence (97.9% vs. 97.7%; p = 0.94), spontaneous potency (41.2% vs. 36.5%; p = 0.41), overall potency (49.4% vs. 45.4%; p = 0.48), IIEF-5 (p = 0.48) and preservation indices (p > 0.7) were comparable. IPSS scores showed no significant difference after weighting (p = 0.54). At 24 months, FFS (89.3% vs. 87.8%; weighted log-rank p = 0.66) and BFS (87.9% vs. 85.6%; weighted log-rank p = 0.79) showed no significant differences, and Cox models revealed no independent hazard signal. Cancer-specific, metastasis-free and overall survival each exceeded 95% (all p > 0.7). Findings were unchanged after excluding low-risk patients.
conclusionsIn this propensity-weighted comparison of hemigland FT, cryoablation and HIFU yielded comparable outcomes. When case-mix is balanced, energy modality exerts minimal influence on short-term cancer control or functional recovery.
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