title: Transrectal high intensity focused ultrasound for the treatment of localized prostate cancer: factors influencing the outcome.
abstract: OBJECTIVE
  Efficacy evaluation of high intensity focused ultrasound (HIFU) treatment for localized prostate cancer and identification of the factors affecting the outcome.
  
  
  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 < or =10 ng/ml (73 vs. 50%, p = 0.02), (2) the Gleason score was < or =6 (81 vs. 46%, p<0.001) and (3) the pretreatment sextant biopsy evidenced 1-4 positive samples (68 vs. 40%, p = 0.01).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Urology Department, Edouard Herriot Hospital, Lyon, France. gelet@lyon151.inserm.fr
authors.forename: A
authors.initials: A
authors.lastname: Gelet
authors.forename: J Y
authors.initials: JY
authors.lastname: Chapelon
authors.forename: R
authors.initials: R
authors.lastname: Bouvier
authors.forename: O
authors.initials: O
authors.lastname: Rouvière
authors.forename: D
authors.initials: D
authors.lastname: Lyonnet
authors.forename: J M
authors.initials: JM
authors.lastname: Dubernard
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000628:therapy*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*