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High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis.

Aoun F, Limani K, Peltier A, Marcelis Q, Zanaty M, Chamoun A, Vanden Bossche M, Roumeguère T, van Velthoven R - Adv Urol (2015)

Bottom Line: Results.Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p < 0.05).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, 1000 Brussels, Belgium.

ABSTRACT
Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ (2) test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p < 0.05). Median oncologic follow-up was 83 months (13-123 months) in the HIFU cohort and 44 months (13-89 months) in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p < 0.05). No statistically significant difference in metastasis-free, cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results.

No MeSH data available.


Related in: MedlinePlus

Kaplan-Meier curves for metastasis-free survival (a) and overall survival (b) stratified according to D'Amico risk classification.
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fig3: Kaplan-Meier curves for metastasis-free survival (a) and overall survival (b) stratified according to D'Amico risk classification.

Mentions: For intermediate risk patients, there was no significant difference in BRFS rates between the brachytherapy and HIFU cohorts according to the Phoenix (58.8% versus 44.9%; HR = 0.47; CI 95%: 0.17–1.13, p = 0.12) and Stuttgart definitions (58.8% versus 42%; HR = 0.41; CI 95%: 0.15–0.97, p = 0.05), respectively. There was no significant difference in the 5-year actuarial metastasis-free survival rates (79.8% versus 85%, HR = 1.08; CI 95%: 0.36–2.95), cancer specific survival rates (92% versus 89%, HR = 0.67; CI 95%: 0.32–1.29), and overall survival (97.5% versus 88%; HR = 0.24; CI 95%: 0.01–1.34), for the brachytherapy and HIFU cohorts, respectively, even after stratifying according to the D'Amico risk (Figure 3).


High Intensity Focused Ultrasound versus Brachytherapy for the Treatment of Localized Prostate Cancer: A Matched-Pair Analysis.

Aoun F, Limani K, Peltier A, Marcelis Q, Zanaty M, Chamoun A, Vanden Bossche M, Roumeguère T, van Velthoven R - Adv Urol (2015)

Kaplan-Meier curves for metastasis-free survival (a) and overall survival (b) stratified according to D'Amico risk classification.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556829&req=5

fig3: Kaplan-Meier curves for metastasis-free survival (a) and overall survival (b) stratified according to D'Amico risk classification.
Mentions: For intermediate risk patients, there was no significant difference in BRFS rates between the brachytherapy and HIFU cohorts according to the Phoenix (58.8% versus 44.9%; HR = 0.47; CI 95%: 0.17–1.13, p = 0.12) and Stuttgart definitions (58.8% versus 42%; HR = 0.41; CI 95%: 0.15–0.97, p = 0.05), respectively. There was no significant difference in the 5-year actuarial metastasis-free survival rates (79.8% versus 85%, HR = 1.08; CI 95%: 0.36–2.95), cancer specific survival rates (92% versus 89%, HR = 0.67; CI 95%: 0.32–1.29), and overall survival (97.5% versus 88%; HR = 0.24; CI 95%: 0.01–1.34), for the brachytherapy and HIFU cohorts, respectively, even after stratifying according to the D'Amico risk (Figure 3).

Bottom Line: Results.Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p < 0.05).Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Jules Bordet Institute, Université Libre de Bruxelles, 1000 Brussels, Belgium.

ABSTRACT
Purpose. To evaluate postoperative morbidity and long term oncologic and functional outcomes of high intensity focused ultrasound (HIFU) compared to brachytherapy for the treatment of localized prostate cancer. Material and Methods. Patients treated by brachytherapy were matched 1 : 1 with patients who underwent HIFU. Differences in postoperative complications across the two groups were assessed using Wilcoxon's rank-sum or χ (2) test. Kaplan-Meier curves, log-rank tests, and Cox regression models were constructed to assess differences in survival rates between the two groups. Results. Brachytherapy was significantly associated with lower voiding LUTS and less frequent acute urinary retention (p < 0.05). Median oncologic follow-up was 83 months (13-123 months) in the HIFU cohort and 44 months (13-89 months) in the brachytherapy cohort. Median time to achieve PSA nadir was statistically shorter in the HIFU. Biochemical recurrence-free survival rate was significantly higher in the brachytherapy cohort compared to HIFU cohort (68.5% versus 53%, p < 0.05). No statistically significant difference in metastasis-free, cancer specific, and overall survivals was observed between the two groups. Conclusion. HIFU and brachytherapy are safe with no significant difference in cancer specific survival on long term oncologic follow-up. Nonetheless, a randomized controlled trial is needed to confirm these results.

No MeSH data available.


Related in: MedlinePlus