SIR 2024
Men's Health
Aniket Joglekar, MD
Clinical Research Associate
David Geffen School of Medicine at UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
James Sayre, PhD
Professor
David Geffen School of Medicine at UCLA
Disclosure information not submitted.
Steven Raman, MD, FSAR, FSIR
Professor of Radiology, Urology and Surgery
David Geffen School of Medicine At UCLA
Financial relationships: Full list of relationships is listed on the CME information page.
IRB approved, HIPAA compliant study cohort: 9 PTS, 58 to 73 years of age (mean age: 67 years) with biopsy confirmed PCa, clinical stage < T2b, GG1 and GG2, PSA ≤15 ng/ml, and PV ≤ 90 cubic centimeters (cc). PTS underwent treatment from October 2017 to January 2023. The International Prostate Symptom Score (I-PSS), the Quality of Life (QoL), the Sexual Health Inventory for Men (SHIM) scores, and 3D-contoured mpMRI prostate volume were completed at baseline and then at up to 8 timepoints post TULSA [1-, 3-, 6-, 12-, 24-, 36-, 48-, and 60-months (mo)]. Statistical linear modeling was used for correlating baseline and follow up questionnaires with mpMRI volume.
Results:
Mean mpMRI PV decreased from 45.5 cc at baseline to 20.5 cc at 6-mo (55% volume reduction rate) (VRR) for all PTS; 46.7 cc at baseline to 7.2 cc (85% VRR) at 60-mo (6 PTS). Mean I-PSS decreased from 19.4 points (pt) at 1-mo to 8.7 pt (-10.7 pt) at 6-mo for all PTS; 17.0 pt at 1-mo to 7.8 pt (-9.2 pt) at 60-mo (6 PTS). Mean QoL decreased from 3.2 pt at 1-mo to 2.1 pt (-1.1 pt) at 6-mo for all PTS; decreased from 2.0 pt at 1-mo to 1.7 pt (-0.3 pt) at 60-mo (6 PTS). Mean SHIM decreased from 17.4 pt at 1-mo to 7.8 pt (-9.6 pt) at 6-mo for all PTS; increased from 14.0 pt at 1-mo to 19 pt (+5.0 pt) at 60-mo (6 PTS). Fitting a linear model to I-PSS (y=I-PSS, x=mo) and linear model to PV (y=PV, x=mo) yielded negative slope coefficients. Average I-PSS slope coefficient was -1.56 (2.33) and the average PV slope coefficient was -1.67 (2.36). The correlation of I-PSS score coefficients and PV coefficients was 0.77 with 95% confidence level (CL) (0.210, 0.948) significant at 0.016. Fitting a linear model to QoL (y=QoL, x=mo) and linear model to PV (y=PV, x=mo) yielded negative slope coefficients for each model. Average QoL slope coefficient was -0.196 (0.303) and average prostate volume slope coefficient was -1.67 (2.36). The correlation of QoL questionnaire coefficients and prostate volume coefficients was 0.948 with 95% CL (0.734, 0.991) significant at < =0.001.
Conclusion:
PTS with GG1 and GG2 PCa treated with TULSA resulted in I-PSS and QoL questionnaire scores that trend down and SHIM scores that trend up over time as the prostate volume decreases.