https://doi.org/10.4081/aiua.2022.4.413

Medium-term oncological outcomes of intermediate-risk prostate cancer treated with HIFU or cryotherapy. A single center 10-year experience

Vol. 94 No. 4 (2022)
Submitted: October 21, 2022
Accepted: October 30, 2022
Published: December 27, 2022
Prostatic neoplasms, Cryotherapy, Focal therapy, Ablation
Abstract Views: 724
PDF: 418
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Authors

Nuno Dias
nunodiasds@gmail.com
https://orcid.org/0000-0003-3186-8657
Urology Department, Institut Mutualiste Montsouris, Paris, France; Urology Department, São João Hospitalar and University Center, Porto, Portugal.
Lara Rodriguez-Sanchez
Urology Department, Institut Mutualiste Montsouris, Paris, France.
Gianmarco Colandrea
Urology Department, Institut Mutualiste Montsouris, Paris, France; Unit of Urology, Division of Experimental Oncology, URI Urological Research Institute, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
Petr Macek
Urology Department, Institut Mutualiste Montsouris, Paris, France.
Xavier Cathelineau
Urology Department, Institut Mutualiste Montsouris, Paris, France.

Objectives: Focal therapies (FTs) are promising techniques for the treatment of localized prostate cancer. We assessed the medium-term oncological outcomes of intermediate-risk prostate cancer (PCa) treated with HIFU or cryotherapy.
Materials and methods: One-hundred and fifty consecutive patients with intermediate-risk PCa, treated between 2009 and 2018 at a single center were included. Primary study outcome was failure-free survival (FFS), defined as absence of additional treatment, systemic progression or prostate cancer related death.
Results: Thirty-seven (25%) patients underwent cryotherapy and 113 (75%) HIFU. Median age was 69 (IQR 62-72) years, with 36 (24%) presenting palpable disease on rectal examination, and median total PSA of 7.85 (IQR 5.75-10.62) ng/mL. Patients were followed for a median of 61 (IQR 48-82) months. FFS at 2 and 4 years was of 75.6% and 53.6%, respectively. Survival from whole gland or systematic treatment at 2 and 4 years was of 78.9% and 53.9%, respectively. Patients with FFS presented lower total PSA nadir (1.89 vs 3.25 ng/mL, p < 0.001), higher % PSA reduction at 3 months (66.1% vs 49.3%, p < 0.001), and at nadir (75.5% vs 55.8%, p < 0.001). Other characteristics such has the treatment modality, age, prostate size, initial total PSA, cT stage, International Society of Urological Pathology (ISUP), tumor location and biopsy results by region did not differ between patients failing and not failing FT. Complications were uncommon (13%), with only onr (1%) patient having Clavien-Dindo grade > II. No deaths due to treatment were registered.
Conclusions: At medium-term, FTs for intermediate-risk PCa presented good oncological results, with an excellent safety profile.

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How to Cite

Dias, N., Rodriguez-Sanchez, L., Colandrea, G., Macek, P., & Cathelineau, X. (2022). Medium-term oncological outcomes of intermediate-risk prostate cancer treated with HIFU or cryotherapy. A single center 10-year experience. Archivio Italiano Di Urologia E Andrologia, 94(4), 413–419. https://doi.org/10.4081/aiua.2022.4.413
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