Prostate arterial chemoembolization for treatment of refractory hematuria and urinary retention in patients with localized advanced prostate cancer.

To evaluate the safety and efficacy transcatheter arterial chemoembolization (TACE) for the treatment of refractory gross hematuria (RGH) and urinary retention (UR) secondary to localized advanced prostate cancer (PCa).

Thirty-two patients (mean age 72.5 years, range 60-89) with advanced PCa-related RGH that failed conventional therapy were included. Twenty-two of these patients had catheter-dependent due to PCa-related UR. TACE was performed with epirubicin (EPI)-eluting HepaSpheres (HS) plus intra-arterial (IA) infusion of docetaxel. Technical success, adverse events (AEs), overall survival (OS), control of RGH, removal of indwelling catheters, and local disease control, were evaluated.

Technical success was achieved in 100% without major AEs. Mean follow up post-TACE was 27 months (range 8-56 months) with a mean OS of 30 months. GRH stopped within 5 days after TACE in all patients, 26 (86.7%) of these patients exhibited good bleeding control during a mean follow-up of 24 months; 17 (77.3%) of the 22 patients with UR had recovered spontaneous urination, 15 (88.2%) patients were catheter-free at their last follow-up with a mean of 24 months. BS was obtained in 73.3% (22/30) of patients at a mean follow-up of 29 months. At the last visit, 22 patients had a mean of 36 months follow-up and the mean percentage reduction in prostate volume was 55.5%, with a statistically different from baseline (P = 0.022). Negative biopsy results were obtained in 84.2% (16/19) of the patients at 12-47 months after TACE. Compared with baseline values, there was a significant improvements in IPSS, QoL, Qmax, and PVR (all P < 0.05).

TACE using EPI-eluting HS plus IA infusion of docetaxel is a safe and effective treatment option for the advanced PCa patients with GRH and UR, and it could be considered as an alternative if there was no other therapeutic choice.

Prostate cancer and prostatic diseases. 2022 Mar 05 [Epub ahead of print]

Mao Qiang Wang, Jin Long Zhang, Feng Duan, Bing Yuan, Hainan Xin, Jin Xin Fu, Hui Yi Ye, Hong Kai Yu, Dui-Ping Feng, Kai Cheng, Xiu Jun Zhang

Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China. ., Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, PR China., Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China., Department of Diagnostic Radiology, Chinese PLA General Hospital, Beijing, 100853, P. R. China., Department of Urology, Chinese PLA General Hospital, Beijing, 100853, P. R. China., Department of Oncology and Vascular Intervention, The First Hospital of Shanxi Medical University, Taiyuan, 030001, China., Department of Interventional Radiology, Qingdao Municipal Hospital, Qingdao, 266071, China., Department of Interventional Radiology, Tianjin Nankai Hospital, Tianjin, 300193, China.

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