A Annoot1, J Olivier2,3,4, P Valtille2, V Deken5, X Leroy3,6, P Puech3,4,7, A Villers2,3,4. 1. Department of Urology, CHRU Lille, Lille University, Lille, France. annootarthur@gmail.com. 2. Department of Urology, CHRU Lille, Lille University, Lille, France. 3. University Lille, 59000, Lille, France. 4. INSERM, ONCO-THAI U1189, 59037, Lille, France. 5. Department of Biostatistics, University Lille, CHU Lille, EA 2694, 59000, Lille, France. 6. Department of Pathology, CHRU Lille, Lille University, Lille, France. 7. Department of Radiology, CHRU Lille, Lille University, Lille, France.
Abstract
PURPOSE: To analyse the impact of the presence of extra-target non-clinically significant cancer (NCSC) after high-intensity focused ultrasound (HIFU) hemiablation on oncological results. To analyse radical treatment free survival (RTFS) rates at 2-3 years follow-up. METHODS: Retrospective single-centre study of 55 patients treated by primary HIFU hemiablation from 2010 to 2016. Inclusion criteria were unilateral MRI detected CSC, stage ≤ T2b, Gleason score (GS) ≤ 7, at least 6 mm distant from prostate apex. MRI with systematic and targeted biopsies was performed at diagnosis. Follow-up included clinical examination, PSA every 6 month, MRI and biopsies at 1 year and in case of PSA elevation. HIFU retreatment was possible. Whole-gland treatment was indicated in case of positive biopsies with GS ≥ 7 or maximum cancer core length > 5 mm, any GS. RESULTS: Mean follow-up was 33 months (SD: 17-49 months). Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS at univariate analysis (p = 0.29). 10 (18%) patients had a salvage whole-gland treatment after a median follow-up of 26 months (IQR 17-28). RTFS at 2 and 3 years were 92% and 80%. CONCLUSION: Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS. NCSC lesion can be left untreated and actively monitored. RTFS was 80% at 3 years which support the concept of focal/partial treatment as a treatment option of CSC prostate cancer.
PURPOSE: To analyse the impact of the presence of extra-target non-clinically significant cancer (NCSC) after high-intensity focused ultrasound (HIFU) hemiablation on oncological results. To analyse radical treatment free survival (RTFS) rates at 2-3 years follow-up. METHODS: Retrospective single-centre study of 55 patients treated by primary HIFU hemiablation from 2010 to 2016. Inclusion criteria were unilateral MRI detected CSC, stage ≤ T2b, Gleason score (GS) ≤ 7, at least 6 mm distant from prostate apex. MRI with systematic and targeted biopsies was performed at diagnosis. Follow-up included clinical examination, PSA every 6 month, MRI and biopsies at 1 year and in case of PSA elevation. HIFU retreatment was possible. Whole-gland treatment was indicated in case of positive biopsies with GS ≥ 7 or maximum cancer core length > 5 mm, any GS. RESULTS: Mean follow-up was 33 months (SD: 17-49 months). Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS at univariate analysis (p = 0.29). 10 (18%) patients had a salvage whole-gland treatment after a median follow-up of 26 months (IQR 17-28). RTFS at 2 and 3 years were 92% and 80%. CONCLUSION: Presence or not of an extra-target NCSC in the untreated part of the gland had no impact on RTFS. NCSC lesion can be left untreated and actively monitored. RTFS was 80% at 3 years which support the concept of focal/partial treatment as a treatment option of CSC prostate cancer.
Authors: Arnas Bakavicius; Giancarlo Marra; Petr Macek; Cary Robertson; Andre L Abreu; Arvin K George; Bernard Malavaud; Patrick Coloby; Pascal Rischmann; Marco Moschini; Ardeshir R Rastinehad; Abhinav Sidana; Armando Stabile; Rafael Tourinho-Barbosa; Jean de la Rosette; Hashim Ahmed; Thomas Polascik; Xavier Cathelineau; Rafael Sanchez-Salas Journal: Int Braz J Urol Date: 2022 Mar-Apr Impact factor: 1.541