Focal therapy with high-intensity focused ultrasound for prostate cancer in the elderly: a feasibility study with 10 years follow-up
Int. braz. j. urol
; 37(2): 213-222, Mar.-Apr. 2011. graf, tab
Article
en En
| LILACS
| ID: lil-588994
Biblioteca responsable:
BR1.1
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 ANDMETHODS:
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
LILACS
Asunto principal:
Neoplasias de la Próstata
/
Ultrasonido Enfocado Transrectal de Alta Intensidad
Tipo de estudio:
Guideline
/
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Aged80
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Humans
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Male
Idioma:
En
Revista:
Int. braz. j. urol
Asunto de la revista:
UROLOGIA
Año:
2011
Tipo del documento:
Article
País de afiliación:
Francia
Pais de publicación:
Brasil