Novosti
|
This journal is indexed in Scopus |
|---|
Year 2016 Vol. 24 No 5
UROLOGY
R.N. FOMKIN, T.V. SHATYLKO
PSA NADIR AS A BASIC PREDICTOR OF LOCALIZED PROSTATE CANCER RECURRENCE AFTER HIFU-ABLATION
SBEE HPE "Saratov State Medical University named after V.I. Razumovsky",
Research Institute of Fundamental and Clinical Uronephrology,
Saratov.
The Russian Federation
Objectives. To assess whether prostate-specific antigen (PSA) nadir is an independent predictor of recurrence and disease-free survival after high-intensity focused ultrasound (HIFU) in localized prostate cancer, using ASTRO new criteria.
Methods. Clinical cases of patients (n=103) after HIFU-ablation (Ablatherm, France) with the localized prostate cancer without previous hormonal therapy were analyzed, retrospectively. Patients were observed regularly at control visits every 3 months. Recurrence was defined by the revised ASTRO criteria (PSA 2 ng/ml or more above the nadir, positive biopsy, appointment of rescue therapy). The patients were divided into three groups depending on the level of PSA nadir: Group I – 0,2 ng/ml or less; group II, – 0,21-1 ng/ml; Group III – more than 1 ng/ml.
Relapse-free survival was calculated using the method of mortality tables. The log rank test was used to compare the constructed Kaplan-Meier curves.
Results. Median follow-up was 4,9 (3-8,6) years. The average time to reach PSA nadir was 6,4±5,1 months. PSA nadir of 0,2 ng/ml or less was achieved in 64% of patients, 0,21-1 ng/ml – 22,3% of the patients more than
1 ng/ml – 13,6%. The recurrence rate was 4,5%, 30,4% and 100%, respectively (p<0,001) in those groups. Five-year actuarial disease-free survival in those groups was 95%, 55% and 0%, respectively (p<0,001).
Conclusion. The level of PSA nadir after HIFU-ablation correlates with a high degree of statistical significance with the probability of recurrence and disease-free survival, which can be applied in a real clinical practice. Promising oncological result may be expected in case of reaching PSA nadir 0,2 ng/mL or less.
- Gelet A, Chapelon JY, Bouvier R, Rouvière O, Lasne Y, Lyonnet D, et al. Transrectal high-intensity focused ultrasound: minimally invasive therapy of localized prostate cancer. J Endourol. 2000 Aug;14(6):519-28.
- Blana A, Rogenhofer S, Ganzer R, Lunz JC, Schostak M, Wieland WF, et al. Eight years' experience with high-intensity focused ultrasonography for treatment of localized prostate cancer. Urology. 2008 Dec;72(6):1329-33; discussion 1333-34. doi: 10.1016/j.urology.2008.06.062.
- Uchida T, Sanghvi NT, Gardner TA, Koch MO, Ishii D, Minei S, et al. Transrectal high-intensity focused ultrasound for treatment of patients with stage T1b-2n0m0 localized prostate cancer: a preliminary report. Urology. 2002 Mar;59(3):394-8; discussion 398-9.
- Fomkin RN, Voronina ES, Popkov VM, Masliakova GN, Bliumberg BI. Trekhletnie rezul'taty lecheniia lokalizovannogo raka prostaty vysokointensivnym sfokusirovannym ul'trazvukom [Three-year results of the treatment of localized prostate cancer by high-intensity focused ultrasound]. Urologiia. 2014;(1):37-44.
- van den Broeck T, Arfy N, van den Bergh R, Yuan Y, Lam T, Mottet N. How does biochemical recurrence following curative treatment for prostate cancer impact on overall survival, cancer-specific survival and development of metastatic disease? PROSPERO. 2015. doi: 10.15124/CRD42015026807.
- Lee HM, Hong JH, Choi HY. High-intensity focused ultrasound therapy for clinically localized prostate cancer. Prostate Cancer Prostatic Dis. 2006;9(4):439-43.
- Blana A, Brown SC, Chaussy C, Conti GN, Eastham JA, Ganzer R, et al. High-intensity focused ultrasound for prostate cancer: comparative definitions of biochemical failure. BJU Int. 2009 Oct;104(8):1058-62. doi: 10.1111/j.1464-410X.2009.08518.x.
- Ganzer R, Robertson CN, Ward JF, Brown SC, Conti GN, Murat FJ, et al. Correlation of prostate-specific antigen nadir and biochemical failure after high-intensity focused ultrasound of localized prostate cancer based on the Stuttgart failure criteria - analysis from the @-Registry. BJU Int. 2011 Oct;108(8 Pt 2):E196-201. doi: 10.1111/j.1464-410X.2011.10091.x.
- Zelefsky MJ, Kuban DA, Levy LB, Potters L, Beyer DC, Blasko JC, et al. Multi-institutional analysis of long-term outcome for stages T1-T2 prostate cancer treated with permanent seed implantation. Int J Radiat Oncol Biol Phys. 2007 Feb 1;67(2):327-33.
- Poissonnier L, Chapelon JY, Rouvière O, Curiel L, Bouvier R, Martin X, et al. Control of prostate cancer by transrectal HIFU in 227 patients. Eur Urol. 2007 Feb;51(2):381-87.
- Berge V, Baco E, Dahl AA, Karlsen SJ. Health-related quality of life after salvage high-intensity focused ultrasound (HIFU) treatment for locally radiorecurrent prostate cancer. Int J Urol. 2011 Sep;18(9):646-51. doi: 10.1111/j.1442-2042.2011.02815.x.
410054, the Russian Federation,
Saratov, Bolshaya Sadovaya st., 137/7.
Clinical Hospital named after SR Mirotvortseva SSMU,
department of urology,
Research Institute for Fundamental and Clinical Uronephrology.
Tel: +7 927 123-38-01
E-mail: rnfomkin@mail.ru
Fomkin Roman Nikolaevich
Fomkin R.N. PhD, Ass. Professor of department of urology, SBEE HPE "Saratov State Medical University named after V.I.Razumovsky", Senior Researcher, Research Institute of Fundamental and Clinical Uronephrology.
Shatylko T.V. Post-graduate student, SBEE HPE "Saratov State Medical University named after V.I.Razumovsky", Research Institute of Fundamental and Clinical Uronephrology.
Article in the .pdf format
