Transrectal High Intensity Focused Ultrasound for the Treatment of Localized Prostate Cancer: Factors Influencing the OutcomeGelet A. · Chapelon J.Y. · Bouvier R. · Rouvière O. · Lyonnet D. · Dubernard J.M.
aUrology Department, Edouard Herriot Hospital, and bINSERM Unit 281, Lyon, France
Objectives: Efficacy evaluation of high intensity focused ultrasound (HIFU) treatment for localized prostate cancer and identification of the factors affecting the outcome. Patients and Methods: 102 patients with prostate cancer stage T1–T2 and noncandidates for radical prostatectomy have been treated with HIFU (Ablatherm™, EDAP–Technomed). The disease progression (failure) was strictly defined by any positive sample at control biopsies, whatever the prostate–specific antigen (PSA) level, or by 3 consecutive increases in PSA levels in case of negative biopsies. Results: At inclusion, patients’ baseline characteristics were (mean ± standard deviation): age 70.8 (±6.13) years, PSA 8.38 (±4.8) ng/ml, prostate volume 33.3 (±16.71) cm3. The population mean follow–up was 19 months (3–76 months). The overall success rate was 66%. Statistically significant variations of the overall success with a more favorable outcome were observed when (1) the initial PSA level was ≤10 ng/ml (73 vs. 50%, p = 0.02), (2) the Gleason score was ≤6 (81 vs. 46%, p<0.001) and (3) the pretreatment sextant biopsy evidenced 1–4 positive samples (68 vs. 40%, p = 0.01). Conclusion: Results observed after HIFU treatment in localized prostate cancer are now challenging those obtained after radiation therapy. The success rate is influenced by disease–related prognostic factors.
A. Gelet, MD
Urology and Transplantation Department
Edouard Herriot Hospital
F–69437 Lyon Cedex 03 (France)
Tel. +33 472 110 583, Fax +33 472 110 582, E–Mail email@example.com
Accepted after revision: November 14, 2000
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 2, Number of References : 20
Official Organ of the European Association of Urology
Vol. 40, No. 2, Year 2001 (Cover Date: August 2001)
Journal Editor: C.C. Schulman, Brussels
ISSN: 0302–2838 (print), 1421–993X (Online)
For additional information: http://www.karger.ch/journals/eur