PD47-05 PROSPECTIVE COMPARISON OF ONCOLOGICAL OUTCOMES BETWEEN FOCAL CRYOTHERAPY VERSUS FOCAL HIGH-INTENSITY FOCUSED ULTRASOUND IN LOCALIZED PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 2015PD47-05 PROSPECTIVE COMPARISON OF ONCOLOGICAL OUTCOMES BETWEEN FOCAL CRYOTHERAPY VERSUS FOCAL HIGH-INTENSITY FOCUSED ULTRASOUND IN LOCALIZED PROSTATE CANCER Youness Ahallal, Eric Barret, Rafael Sanchez-Salas, Marc Galiano, Francois Rozet, and Xavier Cathelineau Youness AhallalYouness Ahallal More articles by this author , Eric BarretEric Barret More articles by this author , Rafael Sanchez-SalasRafael Sanchez-Salas More articles by this author , Marc GalianoMarc Galiano More articles by this author , Francois RozetFrancois Rozet More articles by this author , and Xavier CathelineauXavier Cathelineau More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2749AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To compare the oncological outcomes of focal cryotherapy with those of focal High-Intensity Focused Ultrasound (HIFU) in patients with localized prostate cancer. METHODS Between 2009 and 2014, 277 patients harboring localized prostate cancer were treated with FT. Of these 277; 149 prospective patients with at least one-year follow-up were included for analysis. The median serum PSA before primary therapy was 6.4 ng/ml (Interquartilrange [IQR]: 3.3-8.6) and 6.2 ng/ml (IQR: 3.5- 8.9) in patients treated with focal cryotherapy and focal HIFU respectively. Clinical stage before focal cryotherapy and focal HIFU was T1C in 78 and 48 patients and T2A in 13 and 10, respectively. Biopsy Gleason score in patients treated with focal cryotherapy and focal HIFU before primary therapy was 6 (3+3) in 75 and 53 patients, 7 (3+4) in 16 and 5 patients; respectively; and 1 patient with a Gleason Score of 7(4+3) was treated with focal cryotherapy. The median serum PSA nadir after focal cryotherapy was 2.9 ng/ml (IQR: 0.5-5.30) and 3.6 ng/ml (IQR: 0.9-6.3) for patients treated with focal HIFU (p=0.18). Treatment failure was defined as any positive control biopsy. Salvage treatment was introduced in case of treatment failure: FT is therefore reconsidered if only one biopsy is positive in the same lobe; otherwise, the patient is offered AS, androgen deprivation therapy (ADT) or salvage robotic-assisted radical prostatectomy (sRARP). RESULTS After 22 (IQR: 12-28) and 19 (12-24) months median follow-up, 43 (47%) and 18 (31%) patients had positive biopsies for cancer (p=0.12): 14 (15.4%) and 8 (13.8%) ipsilateral, 14 (15.4%) and 7 (12.1%) contralateral lobe; and, 15 (16.5%) and 3 (5.2%) bilateral in patients treated with focal cryotherapy and focal HIFU, respectively. In patients treated with focal cryotherapy and focal HIFU, 15 and 4 had Gleason 7 positive control biopsy, respectively; they had therefore salvage radical proatatectomy. 13 and 3 patients had 1 ipsilateral Gleason 6 positive biopsy in patients treated with focal cryotherapy and focal HIFU respectively, out of whom, 9 underwent repeat FT and 7 chose AS. CONCLUSIONS Focal cryotherapy and focal HIFU failure rates were not statistically significant featuring comparable oncological outcomes. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e963 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Youness Ahallal More articles by this author Eric Barret More articles by this author Rafael Sanchez-Salas More articles by this author Marc Galiano More articles by this author Francois Rozet More articles by this author Xavier Cathelineau More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...