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Saussine C., Pan J.H., Lang H., Jacqmin D.
Presented on March, 23 2007
INTRODUCTION & OBJECTIVES: To evaluate HIFU results in localized prostatic cancer.
MATERIAL & METHODS: From 01/2001 to 10/2005, 43 patients with average age of 71 years (53-80) had a localized prostatic cancer with positive biopsies (24 T1, 19 T2, N0, M0 with a PSA < 15ng/ml and a gleason score < 8) treated by HIFU (AblathermTM). Morbidity and complications are reviewed. Remission was based on a negative 3 to 6 months biopsies and/or a stable low PSA. Patients with positive biopsies were treated by a second session. Patients with high persistant PSA and/or positive biopsies after 2 sessions were castrated. Results were analysed as average ± STD.
RESULTS: PSA, Gleason score and prostatic volume were 6.6±3.3ng/ml (0.7-13.9), 5±2 (2-8) et 39±18g (7-95) respectively. A combined TURP was performed in 33 patients. Median follow-up was 29 months (6 to 69 m). Catheter removal was performed at day 4 (2-30). Four patients had retention 2 of them required TURP. A urethral stenosis required urethrotomy. With 1 year follow-up 14 patients need pads (8 need 1 and 6 need 2 to 3 pads per day). Six of the 19 potent patients preoperatively remain potent after treatment.
One patient was lost to follow-up at 6 months and two died at 2 and 3 years from non prostatic cancer causes. Results are based on 40 patients.
- 18 patients had remission after 1 session with negative biopsy and a 6 months-PSA of 0.69ng/ml and a median last PSA of 1.07 ng/ml.
(0.03-5.02) with a median follow-up of 25 months (6 to 57 m)
- 7 patients had remission after 2 sessions with negative biopsy and a one year-PSA of 0.85 ng/ml. With a median follow-up of 44 months (18-69) median last PSA was 0.6 ng/ml (0.07-1.5).
- 7 patients had failure and were castrated.
- 7 patients had no biopsy after 1st or 2nd session and a median one year-PSA of 1.36 ng/ml. With a 24 (6-36) months follow-up median PSA was 1.54 ng/ml.
- 1 patient is planed for a 2nd session because of positive biopsy.
CONCLUSIONS: HIFU in localized prostatic cancer has some but not severe morbidity. Two year remission rate after 1 or 2 sessions is 80% (32 / 40 patients).
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