Control of prostate cancer by transrectal HIFU in 227 patients.
OBJECTIVE
To evaluate the results of high-intensity focused ultrasound (HIFU) treatment of localized prostate cancer with reference to disease-related prognostic factors.


METHODS
Patients with T1-2 localized prostate cancers, prostate specific antigen (PSA) <or=15 ng/ml, Gleason score <or=7, prostate volume <or=40 cc and no previous radical treatment for prostate cancer were treated with the Ablatherm HIFU device. Follow-up included PSA measurements, and prostate biopsies 3 months after HIFU and in cases of rising PSA. Failure was defined as any positive biopsy or a PSA >1 ng/ml with three consecutive rises.


RESULTS
The study included 227 patients. Mean follow-up was 27+/-20 months (12-121 months). Eighty-six percent had negative control biopsies. Median nadir PSA was 0.10 ng/ml. The actuarial 5-year disease-free survival rate (DFSR), combining pathologic and biochemical outcomes, was 66%. DFSR showed a significant decrease when stratified according to initial PSA level: 90% with PSA <or=4 ng/ml versus 57% and 61% with PSA between 4.1 and 10, and between 10.1 and 15 ng/ml, respectively. Incontinence and bladder neck stricture decreased with the treatment procedure standardization from 28% and 31% to 9% and 6%, respectively.


CONCLUSIONS
HIFU for localized prostate cancer offered high control of local disease with low morbidity. The ability to repeat the HIFU treatment is of major interest.
Poissonnier
Laura
L
Urology, Radiology and Pathology Department, Edouard Herriot Hospital, Lyon, France.
Chapelon
Jean-Yves
JY
Rouvière
Olivier
O
Curiel
Laura
L
Bouvier
Raymonde
R
Martin
Xavier
X
Dubernard
Jean Michel
JM
Gelet
Albert
A
D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000628:therapy*; D012007:Rectum; D014464:Ultrasonic Therapy / Q000379:methods