Abstract
Objectives: To evaluate our overall experience in HIFU in the prostate cancer application, for its two main indications: as a primary care and as a salvage therapy after radiation. Material and method: Group 1: patients treated with HIFU as primary care for localized prostate cancer, with a baseline PSA level lower than 30 ng/ml, and with at least 1 year of follow-up were included in this analysis. Group 2: patients with a local recurrence after radiation. They were all treated using the Ablatherm HIFU device (EDAP S.A., France). Results: Group 1: n=242 patients. The mean nadir PSA was 0.63 sd 1.30 ng/ml, and further follow-up evidenced a 81% negative biopsy rate. These results are influenced by the usual prognostic factors (clinical stage, baseline PSA, Gleason score), and, as for the other treatment option, the nadir allows prediction of the patient outcome. Group 2: n=71 patients. After HIFU treatment, 80% of the patients presented negative biopsies, and 61% had a nadir PSA level lower than 0.5 ng/ml, obtained within 3 months. No rectal injury occurred since the use of specific parameters. Conclusion: Transrectal HIFU is a valuable option for prostate cancer, for primary care as well as for salvage therapy.
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