Results of high intensity focused ultrasound treatment of prostate cancer: early Canadian experience at a single center.
Bibliographic record
Abstract
INTRODUCTION: High intensity focused ultrasound (HIFU) is a non-invasive technique that uses focused ultrasound waves to ablate tissue. This retrospective study evaluates the early HIFU experience at a single Canadian center. MATERIALS AND METHODS: Ninety-five patients were treated between March 2006 and December 2007 using the Sonablate-500 device (Focus Surgery, Indianapolis, IN, USA). Follow up occurred at 3 month intervals and included serial prostate-specific antigen (PSA) measurements, assessments of erectile function and continence rates with the international index of erectile function (IIEF) and expanded prostate cancer index composite (EPIC) questionnaires respectively. Early and late complications were also studied. RESULTS: There were 95 patients treated by five urologists. The mean age of patients was 64 years (range 46-91). The majority of men treated had Gleason 6 (n = 53) or Gleason 7 (n = 35) disease. The remainder had Gleason 8 (n = 5) and Gleason 9 (n = 2) prostate cancer. Prostate volume in the pre-treatment group was 30.5 cc (range 14.4 cc-73 cc). Cytoreductive androgen deprivation therapy prior to treatment was administered to 10 men. Post-HIFU with a minimum 6 months follow up (mean 10.62 months), 2% (1/59) of men had de novo moderate to severe erectile dysfunction (IIEF ≤ 11). With a minimum of 6 months follow up (mean 8.85 months), 17% (7/41) of the men had significant incontinence according to their EPIC scores. Early complications included catheter-related problems (n = 10), retention (n = 16), and urosepsis (n = 1). Late complications included need for cystoscopy (n = 25), TURP (n = 6), VIU/dilatation for stricture or bladder neck contracture (n = 13) and self-catheterization (n = 1). Prostatorectal fistula occurred in one patient who had prior radiotherapy. Salvage HIFU following radiation failure was performed in seven men. Recurrence of cancer following HIFU was diagnosed in seven men. Salvage treatment included radical prostatectomy (n = 3), radiation therapy (n = 2), repeat HIFU (n = 1), hormone therapy (n = 1). CONCLUSIONS: In our early experience HIFU treatment for prostate cancer was associated with a moderate rate of complications and failure. Further studies are required to examine long term outcomes with HIFU.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".