Christian P. Pavlovich, MD, examines the use of TULSA in prostate cancer treatment, highlighting its technique, outcomes, and future potential.
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James Wysock, MD, MS, delves into the evolving role of whole gland ablation (WGA) in prostate cancer management, particularly in intermediate- to high-risk cases and challenging clinical scenarios.
In this 20-minute presentation, Dr. Wysock highlights specific patient profiles where WGA may be preferable, including those with prior pelvic radiation, contraindications to surgery or radiotherapy, or elderly patients seeking less invasive yet effective treatment. In the salvage setting, WGA offers a compelling alternative for local recurrences, achieving substantial cancer control while avoiding aggressive surgical or radiation options.
Technological advancements like TULSA and HIFU enhance WGA precision. Challenges such as recurrence rates and in-field failures underscore the need for meticulous treatment planning and expanded ablation margins.
Dr. Wysock advocates for trials to validate WGA as a mainstream option, particularly in patients who cannot undergo radical treatments. This approach aligns with evolving guidelines and patient preferences, underscoring WGA’s potential as a transformative option in prostate cancer care.
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Xiaosong Meng, MD, PhD, explores the ongoing CAPTAIN trial, a multinational, randomized clinical study comparing transurethral ultrasound ablation (TULSA) with radical prostatectomy in patients with intermediate-risk prostate cancer. The CAPTAIN trial builds on the TACT study, which demonstrated the safety and efficacy of whole-gland ablation using TULSA.
In this 11-minute presentation, Dr. Meng outlines the eligibility criteria for the CAPTAIN trial participants and reviews the study schema. The trial aims to provide level 1 evidence of safety and efficacy, addressing the need for robust comparative studies to support guideline adoption of ablative technologies.
The trial evaluates outcomes including quality of life, urinary continence, erectile function, and long-term efficacy, with follow-up extending to 10 years. The study’s findings are anticipated to substantiate the use of TULSA as an effective and patient-preferred alternative to radical prostatectomy, potentially influencing clinical practice and reimbursement policies.
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