Abstract
BackgroundTo evaluate quality of life, functional and oncological outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer.MethodsOne hundred thirty-one patients, treated with TURP and HIFU in a single institution were followed up for oncological and functional outcome. Oncological outcome was quantified by biochemical recurrence free survival using the Stuttgart and Phoenix criteria. Quality of life was assessed by usage of standardized QLQ-C30 and QLQ-PR25 questionnaires. In addition, functional questionnaires such as IPSS and IIEF-5 were used. Complications were assessed by the Clavien-Dindo classification.ResultsOne hundred thirty-one patients with a mean age of 72.8 years (SD: 6.0) underwent HIFU for prostate cancer (29.0% low risk, 58.8% intermediate risk, 12.2% high risk). PSA nadir was 0.6 ng/ml (SD: 1.2) after a mean of 4.6 months (SD: 5.7). Biochemical recurrence free survival defined by Stuttgart criteria was 73.7%, 84.4% and 62.5% for low-, intermediate- and high-risk patients after 22.2 months. Complications were grouped according to Clavien-Dindo and occurred in 10.7% (grade II) and 11.5% (grade IIIa) of cases. 35.1% of patients needed further treatment for bladder neck stricture. Regarding incontinence, 14.3%, 2.9% and 0% of patients had de novo urinary incontinence grade I°, II° and III° and 3.8% urge incontinence due to HIFU treatment. Patients were asked for the ability to have intercourse: 15.8%, 58.6% and 66.7% of patients after non-, onesided and bothsided nervesparing procedure were able to obtain sufficient erection for intercourse, respectively. Regarding quality of life, mean global health score according to QLQ-C30 was 69.4%.ConclusionHIFU treatment for localized prostate cancer shows acceptable oncological safety. Quality of life after HIFU is better than in the general population and ranges within those of standard treatment options compared to literature. HIFU seems a safe valuable treatment alternative for patients not suitable for standard treatment.
Highlights
To evaluate quality of life, functional and oncological outcome after infravesical desobstruction and High intensified focused ultrasound (HIFU) treatment for localized prostate cancer
All patients were treated with the Ablatherm HIFU device (Ablatherm integrated imaging device; EDAP-TMS, Vaulx-en-Velin, France)
HIFU treatment was performed as inpatient procedure in combined spinal and epidural anesthesia
Summary
To evaluate quality of life, functional and oncological outcome after infravesical desobstruction and HIFU treatment for localized prostate cancer. High intensified focused ultrasound (HIFU) is a minimal invasive, thermoablative treatment option for patients with localized prostate cancer. High energetic ultrasound waves cause thermal alteration and cavitation, causing coagulative necrosis and thereby destroying malignant tissue [2, 3]. Since the initial presentation in 1995 [4], several studies have evaluated oncological and functional outcome after HIFU. Recent publications report of 76%, 63% and 57% biochemical free survival after 8 years for low-, intermediate- and high-risk patients [5]. The 10-year prostate cancer specific survival rate and metastasis-free survival rate were 97% and 94%, respectively [5].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call