1356 BIOCHEMICAL VERSUS IMAGING PARAMETERS FOR ASSESSING ONCOLOGICAL OUTCOMES FOLLOWING FOCAL THERAPY FOR LOCALISED PROSTATE CANCER

Abstract

INTRODUCTION AND OBJECTIVES: To compare the oncological results of radial prostatectomy (RP) and High Intensity Focused Ultrasound (HIFU) performed in the same urological department during the same period (2000 – 2005). METHODS: All consecutive patients 70 years old were included in this study. All data were collected prospectively on secured database. Patients treated with HIFU underwent systematic control biopsy and a second HIFU session in case of positive biopsy. RESULTS: A total of 723 patients were included in the study: 423 RP (open: 259, Laparoscopic: 154) and 310 HIFU. Except the mean age (RP: 61 years, HIFU: 64 years, p 0.001) they was no difference between the 2 groups for PSA (RP: 9.2ng/ml, HIFU: 8.5ng/ ml), Gleason score (RP: 6.3 1, HIFU: 6.2 1) and the D’Amico risk group (Low 42.6% vs. 39.5%, intermediate 43.1% vs. 44.8% and high 14.4% vs. 15.7% for RP and HIFU respectively). The mean nadir PSA was significantly different between RP and HIFU: 0.17ng/ml (median: 0.06ng/ml) and 0.72ng/ml (median: 0.16ng/ml). A salvage EBRT was performed in 22.3% of the RP group versus 34.5% in the HIFU group (p 0.01) but the rate of palliative androgen deprivation (AD) was not different: 9.4% for RP and 12.3% for HIFU (p 0.22). At 9 years, no difference was found in the overall survival rate (RP: 93%, HIFU: 89%, p 0.1) and in the cancer specific survival rate (RP: 99%, HIFU: 97%, p 0.31). The metastasis survival rate was 97% for RP and 94% for HIFU (p 0.01). The AD free survival rate was 87% in the RP group and 85% in the HIFU group (p 0.29). CONCLUSIONS: The RP provide a better local control and metastasis free survival rate at 9 years compared to HIFU. However, the specific survival rate and AD survival rate were not different at 9 years between RP and HIFU.