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Pathological, Oncologic and Functional Outcomes of a Prospective Registry of Salvage High Intensity Focused Ultrasound Ablation for Radiorecurrent Prostate Cancer.
Siddiqui, Khurram M; Billia, Michele; Arifin, Andrew; Li, Fan; Violette, Philippe; Chin, Joseph L.
Afiliação
  • Siddiqui KM; Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Billia M; Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Arifin A; Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Li F; Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
  • Violette P; Woodstock Hospital, Woodstock, Ontario, Canada.
  • Chin JL; Division of Urology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada.
J Urol ; 197(1): 97-102, 2017 01.
Article em En | MEDLINE | ID: mdl-27422297
PURPOSE: In this prospective registry we prospectively assessed the oncologic, functional and safety outcomes of salvage high intensity focused ultrasound for radiorecurrent prostate cancer. MATERIALS AND METHODS: A total of 81 men were prospectively recruited and evaluated at regular scheduled study visits to 6 months after high intensity focused ultrasound and thereafter as per standard of care. Transrectal ultrasound guided biopsy was performed at 6 months. The primary end point was absence or histological persistence of disease at 6-month biopsy. Secondary end points included quality of life, biochemical recurrence-free survival, overall survival, cancer specific survival and progression to androgen deprivation therapy. Survival analysis was performed according to the Kaplan-Meier method and multivariate analysis was performed using the log rank (Mantel-Cox) test. RESULTS: Mean ± SD prostate specific antigen before high intensity focused ultrasound was 4.06 ± 2.88 ng/ml. At 6 months 63 men underwent biopsy, of whom 22 (35%) had residual disease. At a mean followup of 53.5 ± 31.6 months median biochemical recurrence-free survival was 63 months. The 5-year overall and cancer specific survival rates were 88% and 94.4%, respectively. Nadir prostate specific antigen less than 0.5 ng/ml was a significant predictor of biochemical recurrence-free survival (p=0.014, 95% CI 1.22-5.87). I-PSS significantly increased (p <0.001) while IIEF-5 scores decreased and the SF-36 score did not change significantly. The rate of rectal fistulization and severe incontinence was 3.7% each. A total of 223 complications were recorded in the 180 days after high intensity focused ultrasound (Clavien-Dindo grade 1-195, grade II-20, grade III-7, grade IVa-1). CONCLUSIONS: Salvage high intensity focused ultrasound appears to be a viable treatment option for radiorecurrent prostate cancer, with acceptable morbidity.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Sistema de Registros / Terapia de Salvação / Ablação por Ultrassom Focalizado de Alta Intensidade / Recidiva Local de Neoplasia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias da Próstata / Sistema de Registros / Terapia de Salvação / Ablação por Ultrassom Focalizado de Alta Intensidade / Recidiva Local de Neoplasia Tipo de estudo: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Humans / Male / Middle aged Idioma: En Ano de publicação: 2017 Tipo de documento: Article