[Eight years of experience with HIFU for prostate cancer: Oncological and functional results]

To study the oncologic and functional results of HIFU as a first-line treatment for localized prostate cancer.

Enrolment of patients between 2006 and 2011 for the first treatment against localized prostate cancer with HIFU (Integrated Imaging(®), EDAP-TMS, Vaulx-en-Velin, France). The biochemical recurrence-free survival was calculated by using the Phoenix criterion (PSA>nadir+2 ng/mL). The functional complications were assessed clinically and through standardised questionnaires.

The condition of 191 patients was assessed at a mean follow-up of 55.5 ± 22.7 months. In 10,1% of the treatments, an incident during the medical procedure was observed with the volume of the prostate (P=0.026) as risk factor. The overall survival, the survival and the metastatic free survival rate were respectively 89.5%, 98.4% and 97.4%. The biochemical free survival rate for 5 years was 87.5%, 69% and 39% respectively for the low, medium and high-risk groups of d'Amico classification. Eighty-six percent of the patients with a PSA nadir ≤ 0.3 ng/mL were relapse free at 5 years. Whereas only 48% of the patients with a nadir>0.3 ng/mL did not. Only 17.8% of the patients had a rescue treatment with an average delay of 31.1 months. The urinary and sexual impairment was significant but 78.1% of the patients were dry at the end of the study. The most common complication found in 18.3% of the patients was the prostatic obstruction.

The oncologic and functional results of the HIFU seem similar to the other first-line treatments results and reveal that the HIFU is a therapeutic option for the treatment of prostate cancer in men over 70 years.

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