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High-intensity focused ultrasound strategies for treating prostate cancer

Asian Journal of Andrology 2024年第6期26卷 595-599页

作者： Xiaobo Wu Yupeng Wu chi-fai ng chi-Hang Yee Peter Ka-Fung chiu SH Ho Urology Centre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong KongChina Department of Urology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350004China

Prostate cancer (PCa) is a significant health concern globally, necessitating effective treatment options. Typical treatment methods for early stage, particularly localized PCa, encompass radical procedures, such as radical prostatectomy (RP) and radiotherapy (RT), and nonradical focal therapy (FT). FT is a focused approach mainly used for treating small lesions limited to a specific zone of the prostate. Its objective is to achieve cancer control when minimizing damage to benign tissue. High-intensity focused ultrasound (HIFU) is one of the most used modalities in FT for the management of PCa. The progress in HIFU technology showcases continuous advancements, offering clinicians a variety of strategies to cater to diverse patient requirements. The advancements include the development of transrectal and transurethral HIFU machines that offer enhanced treatment distances, magnetic resonance imaging (MRI) fusion capabilities, real-time monitoring, and precise ablation. These improvements contribute to increased treatment effectiveness and better outcomes for patients. This narrative review aims to summarize the use of HIFU technology and its evolution, offering diverse options to clinicians, and explores the safety, effectiveness, and quality of different HIFU strategies, such as whole-gland ablation, hemigland ablation, and focal ablation. We conclude that nonwhole-gland HIFU offers similar cancer control with better short-term functional outcomes and fewer complications compared to whole-gland ablation. Combining HIFU with transurethral resection of the prostate (TURP) improves urinary function and reduces catheterization time. Focal ablation and hemigland ablation show promise in achieving cancer control when preserving continence and potency.

关键词： ablation focal therapy high-intensity focused ultrasound prostate cancer strategy

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Time trend and characteristics of prostate cancer diagnosed in Hong Kong(china)in the past two decades

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Asian Journal of Andrology 2019年第1期21卷 104-106页

作者： Ho-fai Wong chi-Hang Yee Jeremy YC Teoh Samson YS Chan Peter KF chiu Ho-Yuen Cheung Simon SM Hou chi fai ng S H.Ho Urology Centre Department of SurgeryThe Chinese University of Hong KongHong KongChina

Dear Editor, Prostate cancer is an important disease worldwide)In 2015 it was the third most common cancer diagnosed in male in Hong Kong (china) and the incidence of prostate cancer has been rising in the past 15 years. Meanwhile,with increasing public awareness,health education, presentation,and detection of prostate cancer maybe ***, we would like to review how the epidemiology of prostate cancer in Hong Kong (china)had changed in the past two decades.

关键词： prostate cancer Time trend

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Risk of cardiovascular thrombotic events after surgical castration versus gonadotropin-releasing hormone agonists in chinese men with prostate cancer

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Asian Journal of Andrology 2015年第3期17卷 493-496页

作者： Jeremy YC Teoh Samson YS Chan Peter KF chiu Darren MC Poon Ho-Yuen Cheung Simon SM Hou chi-fai ng Department of Surgery Division of Urology Prince of Wales Hospital The Chinese University of Hong Kong Shatin Hong Kong China Department of Clinical Oncology Prince of Wales Hospital The Chinese University of Hong Kong Shatin Hong Kong China Department of Surgery Division of Urology North District Hospital Hong Kong China

We investigated the cardiovascular thrombotic risk after surgical castration （SC） versus genadotmpin-releasing hormone agonists （GnRHa） in chinese men with prostate cancer. All chinese prostate cancer patients who were treated with SC or GnRHa from year 2000 to 2009 were reviewed and compared. The primary outcome was any new-onset of cardiovascular thrombotic events after SC or GnRHa, which was defined as any event of acute myocardial infarction or ischemic stroke. The risk of new-onset cardiovascular thrombotic event was compared between the SC group and the GnRHa group using Kaplan-Meier method. Multivariate Cox regression analysis was performed to adjust for other potential confounding factors. A total of 684 chinese patients was included in our study, including 387 patients in the SC group and 297 patients in the GnRHa group. The mean age in the SC group （75.3 ~ 7.5 years） was significantly higher than the GnRHa group （71.8 ~ 8.3 years）（P 〈 0.001）. There was increased risk of new cardiovascular thrombotic events in the SC group when compared to the GnRHa group upon Kaplan-Meier analysis （P= 0.014）. Upon multivariate Cox regression analysis, age （hazard ratio [HR] 1.072, 95% confidence interval [CI] 1.04-1.11, P 〈 0.001）, hyperlipidemia （HR 2.455, 95% Cl 1.53-3.93, P 〈 0.001）, and SC （HR 1.648, 95% CI 1.05-2.59, P = 0.031） were significant risk factors of cardiovascular thrombotic events. In conclusion, SC was associated with increased risk of cardiovascular thrombotic events when compared to GnRHa. This is an important aspect to consider while deciding on the method of androgen deprivation therapy, especially in elderly men with known history of hyperlipidemia.

关键词： androgen deprivation therapy chinese population cardiovascular events myocardial infarction prostate cancer stroke

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Transurethral resection of prostate for acute urinary retention is linked to shorter survival in younger men

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Asian Journal of Andrology 2019年第5期21卷 468-472页

作者： Jeremy Yuen-Chun Teoh chi-Kwok Chan Maggie Haitian Wang chi-Ho Leung Eddie Shu-Yin Chan Peter Ka-Fung chiu chi-Hang Yee Hon-Ming Wong Simon See-Ming Hou chi-fai ng S.H.Ho Urology Centre Department of SurgeryPrince of Wales HospitalThe Chinese University of Hong KongHong KongChina Division of Biostatistics JC School of Public Health and Primary CareThe Chinese University of Hong KongHong KongChina Division of Urology Department of SurgeryNorth District HospitalHong KongChina Division of Urology Department of SurgeryAlice Ho Miu Ling Nethersole HospitalHong KongChina

It is largely unknown whether lower urinary tract symptoms(LUTS)or acute retention of urine(AROU)is linked to shorter life expectancy in *** conducted a multicenter,retrospective database analysis of patients undergoing transurethral resection of prostate(TURP)to study their *** Cox regression analysis and Kaplan-Meier analysis with stratification to age and indication of TURP were *** further performed an age-and sex-matched survival analysis with the general population using data from the Census and Statistics Department of the Hong Kong Special Administrative Region(Hong Kong,china).From January 2002 to December 2012,3496 patients undergoing TURP were included in our study,with 1764 patients in the LUTS group and 1732 patients in the AROU *** age,ischemic heart disease,cerebrovascular accident,and AROU were risk factors of *** aged80 *** to the general population,younger patients in the LUTS group appeared to have better survival(nger patients in the AROU group had worse survival(80 years,survival was similar with the general population in both the LUTS and AROU *** conclusion,AROU at young age was associated with mortality,while early detection and management of LUTS may improve survival.

关键词： acute retention of urine lower urinary tract symptoms mortality transurethral resection of prostate

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Approximate Output Regulation with the RTAC System

Approximate Output Regulation with the RTAC System

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第十九届中国控制会议

作者： chi fai ng Department of Automation and Computer-Aided Engineering The chinese University of Hong Kong Shatin N．T．Hong Kong

＜正＞The rotational/translational actuator （RTAC） system has been served as a testbed for evaluating various nonlinear control methodologies. This paper will study the asymptotic disturbance rejection problem of the RTAC system which aims to design a feedback controller such that the closed-loop system is stable and the output of the closed-loop system can asymptotically approach zero in spite of a sinusoidal disturbance. This problem cannot be solved by conventional inversion based control methods since RTAC is a nonminimum phase system. This paper will formulate this problem as an output regulation problem, and solve it approximately by applying a neural network based approach developed recently by the authors. Computer simulations indicate the significant advantages of our controller over the linear

关键词： Regulator equations nonlinear output regulation problem neural networks rota-tional/translational actuator (RTAC).

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A prospective cohort of men with localized prostate cancer on active surveillance protocol in Hong Kong,china:what did we learn?

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Asian Journal of Andrology 2024年第3期26卷 245-249页

作者： Xiaobo Wu Ivan ching-Ho Ko Cindy Yeuk-Lam Hong Samuel chi-Hang Yee Jeremy Yuen-Chun Teoh Samson Yun-Sang Chan Ho-Man Tam chi-Kwok Chan chi-fai ng Peter Ka-Fung chiu SH Ho Urology Centre Department of SurgeryFaculty of MedicineThe Chinese University of Hong KongHong KongChina

This study aimed to report the outcomes of active surveillance(AS)in the management of low-risk prostate cancer(PCa).It recruited87 men who were prospectively followed up according to the Prostate Cancer Research International Active Surveillance(PRIAS)protocol with local adaptation at SH Ho Urology Centre,Prince of Wales Hospital,Hong Kong,*** investigated the predictorsof disease progression and found that baseline prostate-specific antigen density(PSAD)and the presence of the highest ProstateImaging-Reporting and Data System(PI-RADS)score 5 lesion on magnetic resonance imaging(MRI)are significantly correlatedwith disease ***,men with PSAD>0.2 ng ml^(−2)or PI-RADS 4 or 5 lesions had significantly worse upgradingfree survival compared to those with PSAD≤0.2 ng ml−2 and PI-RADS 2 or 3 *** study concludes that AS is a safe andeffective management strategy for selected patients to defer radical treatment and that most disease progression can be detectedafter the first repeated *** combination of PSAD>0.2 ng ml^(−2)and PI-RADS 4 or 5 lesions may serve as a useful predictorof early disease progression and provide a guide to optimize follow-up protocols for men in different risk groups.

关键词： active surveillance cohort localized prostate cancer

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Late retroperitoneal recurrence of hepatocellular carcinoma 12 years after initial diagnosis

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World Journal of Gastroenterology 2010年第17期16卷 2187-2189页

作者： Tiffany Cho-Lam Wong Ka-fai To Simon See-Ming Hou Sidney Kam-Hung Yip chi-fai ng Department of Surgery Prince of Wales HospitalThe Chinese University of Hong Kong Department of Anatomical and Cellular Pathology The Chinese University of Hong Kong

Hepatocellular carcinoma (HCC) is an aggressive tumor with poor long-term ***,we present an unusual patient with a solitary recurrence of HCC in the right kidney 12 years after the initial *** illustrates the importan... 详细信息

关键词： Hepatocellular carcinoma Late recurrence Metastasis Retroperitoneal

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The combined role of MRI prostate and prostate health index in improving detection of significant prostate cancer in a screening population of chinese men

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Asian Journal of Andrology 2023年第6期25卷 674-679页

作者： Peter KF chiu Thomas YT Lam chi-fai ng Jeremy YC Teoh Carmen CM Cho Hiu-Yee Hung Cindy Hong Monique J Roobol Winnie CW Chu Samuel YS Wong Joseph JY Sung SH Ho Urology Centre Department of SurgeryThe Chinese University of Hong KongHong Kong SARChina The Jockey Club School of Public Health and Primary Care The Chinese University of Hong KongHong Kong SARChina Department of Imaging and Interventional Radiology The Chinese University of Hong KongHong Kong SARChina Erasmus MC Cancer Institute Erasmus Medical UniversityRotterdam 3015The Netherlands Lee Kong chian School of Medicine Nanyang Technological UniversitySingapore 308232Singapore

Using prostate-specific antigen(PSA)for prostate cancer(PCa)screening led to overinvestigation and overdiagnosis of indolent *** aimed to investigate the value of prostate health index(PHI)and magnetic resonance imaging(MRI)prostate in an Asian PCa screening *** aged 50–75 years were prospectively recruited from a community-based PSA screening *** with PSA 4.0–10.0 ng ml^(−1) had PHI result *** prostate was offered to men with PSA 4.0–50.0 ng ml−1.A systematic prostate biopsy was offered to men with PSA 4.0–9.9 ng ml^(−1) and PHI≥35,or PSA 10.0–50.0 ng ml^(−1).Additional targeted prostate biopsy was offered if they had PI-RADS score≥*** significant PCa(csPCa)was defined as the International Society of Urological Pathology(ISUP)grade group(GG)≥2 or ISUP GG 1 with involvement of≥30%of total systematic *** total,12.8%(196/1536)men had PSA≥4.0 ng ml^(−1).Among 194 men with PSA 4.0–50.0 ng ml^(−1),187(96.4%)received MRI *** them,28.3%(53/187)had PI-RADS≥3 ***,7.0%(107/1536)men were indicated for biopsy and 94.4%(101/107)men received *** the men received biopsy,PCa,ISUP GG≥2 PCa,and csPCa was diagnosed in 42(41.6%),24(23.8%),and 34(33.7%)men,*** with PSA/PHI pathway in men with PSA 4.0–50.0 ng ml^(−1),additional MRI increased diagnoses of PCa,ISUP GG≥2 PCa,and csPCa by 21.2%(from 33 to 40),22.2%(from 18 to 22),and 18.5%(from 27 to 32),*** benefit of additional MRI was only observed in PSA 4.0–10.0 ng ml^(−1),and the number of MRI needed to diagnose one additional ISUP GG≥2 PCa was 20 in PHI≥35 and 94 in PHIng ml^(−1) avoided unnecessary biopsy with the use of PHI and MRI.A screening algorithm with PSA,PHI,and MRI could effectively diagnose csPCa while reducing unnecessary *** benefit of MRI prostate was mainly observed in PSA 4.0–9.9 ng ml^(−1) and PHI≥35 *** was an important risk stratification step for PCa

关键词： magnetic resonance imaging prostate prostate cancer prostate health index prostate-specific antigen screening

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Association of time to prostate-specific antigen nadir and logarithm of prostate-specific antigen velocity after progression in metastatic prostate cancer with prior primary androgen deprivation therapy

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Asian Journal of Andrology 2017年第1期19卷 98-102页

作者： Jeremy YC Teoh James HL Tsu Steffi KK Yuen Peter KF chiu Samson YS Chan Ka-Wing Wong Kwan-Lun Ho Simon SM Hou chi-fai ng Ming-Kwong Yiu Division of Urology Department of Surgery The Chinese University of Hong Kong Prince of Wales Hospital Shatin Hong Kong China Division of Urology Department of Surgery Queen Mary Hospital University of Hong Kong Hong Kong China.

We investigated the association of time to prostate-specific antigen nadir （TTPN） and logarithm of prostate-specific antigen velocity after progression Log（PSAVAP） in metastatic prostate cancer with prior primary androgen deprivation therapy （ADT）. All metastatic prostate cancer patients treated with primary ADT from 2000 to 2009 were reviewed. Patients who developed disease progression were included in the subsequent analyses. Patients were categorized into three groups according to their TTPN： TTPN of 〈3 months, 3-17 months, and 〉17 months. We compared the Log（PSAVAP） between the different TTPN groups using Mann-Whitney U-test and Kruskal-Wallis test. Further multiple linear regression analyses on Log（PSAVAP） were performed to adjust for other potential confounding factors. Among 419 patients who were treated with primary ADT, 306 patients developed disease progression with a median follow-up of 28 months, Longer TTPN was associated with lower Log（PSAVAP）（P = 0.008） within all subgroup analyses （TTPN of 〈3 vs 3-17 months, P = 0.020; TTPN of 3-17 vs 〉17 months, P = 0.009; and TTPN of 〈3 vs 〉17 months, P = 0.001）. Upon multiple linear regression analyses, baseline PSA （regression coefficient 0.001, P = 0.045）, PSA nadir （regression coefficient 0.002, P = 0.040）, and TTPN （regression coefficient -0.030, P = 0.001） were the three factors that were significantly associated with Log（PSAVAP）. In conclusion, a longer TTPN was associated with lower Log（PSAVAP） in metastatic prostate cancer patients following primary ADT. TTPN cut-offs at 3 months and 17 months appeared to have prognostic significance in predicting Log（PSAVAP）. TTPN may serve as a good prognostic indicator in deciding the treatment strategy in patients with disease progression.

关键词： androgen deprivation therapy prostate cancer prostate-specific antigen velocity after progression ti me to prostate-specific antigen nadir

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The Effects of Ganoderma lucidumon Initial Events Related to the Bacillus Calmette-GuérinEfficacy and Toxicity on High-Risk Uroepithelial Cells: An in VitroPreliminary Study

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chinese Medicine 2013年第2期4卷 52-61页

作者： John Wai-Man Yuen Mayur-Danny I. Gohel chi-fai ng Department of Medical Science Tung Wah College Hong Kong China Department of Surgery The Chinese University of Hong Kong Hong Kong China School of Nursing The Hong Kong Polytechnic University Hong Kong China

A novel prophylactic regimen is demanded for preventing bladder cancer recurrence, because of the high side-effect tolls of conventional adjuvant Bacillus Calmette-Guérin (BCG) immunotherapy, in addition to its only moderate efficacy. In vitro and animal studies have demonstrated the anti-cancer properties of a medicinal mushroom called Ganoderma lucidum (GL). In this study, a pre-malignant human uroepithelial cells (HUC-PC) model was utilized to compare the effectiveness between ethanol extract of GL (GLe) and BCG on interleukin-6 (IL-6) secretion and lactate dehydrogenase (LDH) cytotoxicity. Additionally, parameters relevant to the BCG efficacy and safety, including free soluble fibronectin (FN) and cell-surface glycosaminoglycans (GAGs) levels were tested, following the exposure of GLe to the cells. GLe at 100 μg/ml and BCG at 4.8 × 107 CFU were shown to induce equivalent levels of IL-6, suggesting the potential synergism, while the tested concentrations of GLe were non-cytotoxic. During the initial four hours of GLe exposure, the free FN concentrations in harvested media were significantly reduced that might facilitate the binding of BCG for uroepithelial internalization to enhance BCG efficacy. Furthermore, the cell membrane-bound GAGs levels of HUC-PC cells were significant increased in response to GLe to suggest cellular protection from BCG infection. In summary, current findings suggest the potential additive synergism of GLe with the BCG efficacy, as well as its protective effects, and thus reducing the BCG toxicity.

关键词： Ganoderma lucidum Bacillus Calmette-Guérin Bladder Cancer Uroepithelial Cells Synergism

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