This journal is
indexed in Scopus
Year 2016 Vol. 24 No 5
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,
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.
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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
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.