Oncological and functional outcomes of elderly men treated with HIFU vs. minimally invasive radical prostatectomy: A propensity score analysis

• Published in: European journal of surgical oncology 2018-01, Vol.44 (1), p.185-191
• Main Authors: Capogrosso, Paolo, Barret, Eric, Sanchez-Salas, Rafael, Nunes-Silva, Igor, Rozet, François, Galiano, Marc, Ventimiglia, Eugenio, Briganti, Alberto, Salonia, Andrea, Montorsi, Francesco, Cathelineau, Xavier
• Format: Article
• Language: English
• Subjects: Aged; Biopsy; Disease-Free Survival; Extracorporeal Shockwave Therapy - methods; Follow-Up Studies; HIFU; High-Intensity Focused Ultrasound Ablation; Humans; Italy - epidemiology; Male; Minimally Invasive Surgical Procedures - methods; Propensity Score; Prostate cancer; Prostatectomy - methods; Prostatic Neoplasms - diagnosis; Prostatic Neoplasms - mortality; Prostatic Neoplasms - therapy; Radical prostatectomy; Survival Rate - trends; Treatment Outcome; Whole-gland ablation
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2017.11.008

To assess outcomes of whole gland high-intensity focused ultrasound (HIFU) as compared with minimally-invasive radical prostatectomy (MIRP) in elderly patients. Patients aged ≥70 years with, cT1-cT2 disease, biopsy Gleason score (GS) 3 + 3 or 3 + 4 and preoperative PSA ≤10 ng/mL were submitted to either whole-gland HIFU or MIRP. Propensity-score matching analysis was performed to ensure the baseline equivalence of groups. Follow-up visits were routinely performed assessing PSA and urinary function according to the International Continence Score (ICS) and the International Prostatic Symptoms Score (IPSS) questionnaires. Estimated rates of salvage-treatment free survival (SFS) overall-survival (OS), cancer-specific survival (CSS) and metastasis-free survival (MTS) were assessed and compared. Overall, 84 (33.3%) and 168 (66.7%) patients were treated with HIFU and MIRP, respectively. MIRP was associated with a 5-yrs SFS of 93.4% compared to 74.8% for HIFU (p