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Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up
Fegoun, Amine B. El; Barret, Eric; Prapotnich, Dominique; Soon, Shawn; Cathelineau, Xavier; Rozet, François; Galiano, Marc; Sanchez-Salas, Rafael; Vallancien, Guy.
  • Fegoun, Amine B. El; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Barret, Eric; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Prapotnich, Dominique; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Soon, Shawn; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Cathelineau, Xavier; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Rozet, François; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Galiano, Marc; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Sanchez-Salas, Rafael; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
  • Vallancien, Guy; University Paris Descartes. Institute Montsouris. Department of Urology. Paris. FR
Int. braz. j. urol ; 37(2): 213-222, Mar.-Apr. 2011. graf, tab
Article in English | LILACS | ID: lil-588994
ABSTRACT

PURPOSE:

To evaluate the long-term efficacy of prostate cancer control and complication rates, in the elderly, after focal therapy with high-intensity focused ultrasound (HIFU). MATERIALS AND

METHODS:

Between June 1997 and March 2000, patients with localized prostate cancer were included into a focal therapy protocol. Inclusion criteria were PSA < 10 ng/mL, < 3 positive biopsies with only 1 lobe involved, clinical stage < T2a, Gleason score < 7 (3+4), negative CT scan and bone scan. Hemi-ablation of the prostate was performed with the Ablatherm(R) device. Survival, complication rates and urinary continence were evaluated. Control biopsies were performed at 1 year. Treatment failure was defined as a positive biopsy or need for salvage therapy.

RESULTS:

Twelve patients with a mean age 70 years were included. Median follow-up was 10 years. Control prostate biopsies were negative in 11/12 (91 percent) patients. Overall survival was 83 percent (10/12) and cancer specific survival was 100 percent at 10 years. Two patients died from other causes. Recurrence free survival was 90 percent (95 percent CI; 0.71-1) at 5 years, and 38 percent (95 percent CI; 0.04-0.73) at 10 years. Five patients had salvage therapy with repeat HIFU (n = 1) or hormonal therapy (n = 4) and all salvage patients were alive at 10 years. No patients developed lymph node or bone metastasis. No patients suffered from urinary incontinence. International Prostate Symptom Score was stable at 1 year. Complications included two urinary tract infections and one episode of acute urinary retention.

CONCLUSIONS:

Hemi-prostate ablation with HIFU can be safely performed in selected elderly patients with adequate long-term cancer control and low complication rates. Results from larger prospective studies using improved imaging techniques and extensive biopsy protocols are awaited.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Ultrasound, High-Intensity Focused, Transrectal Type of study: Practice guideline / Observational study / Prognostic study Limits: Aged / Aged80 / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2011 Type: Article Affiliation country: France Institution/Affiliation country: University Paris Descartes/FR

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Full text: Available Index: LILACS (Americas) Main subject: Prostatic Neoplasms / Ultrasound, High-Intensity Focused, Transrectal Type of study: Practice guideline / Observational study / Prognostic study Limits: Aged / Aged80 / Humans / Male Language: English Journal: Int. braz. j. urol Journal subject: Urology Year: 2011 Type: Article Affiliation country: France Institution/Affiliation country: University Paris Descartes/FR