Article

[HIFU for prostate cancer in patients with a history of severe colorectal disease].

Service d'urologie et chirurgie de la transplantation, hôpital Édouard-Herriot, Lyon, France.
Progrès en Urologie (impact factor: 0.58). 10/2011; 21(9):619-24. DOI:10.1016/j.purol.2011.03.005 pp.619-24
Source: PubMed

ABSTRACT To report the functional and oncological outcomes of HIFU for prostate cancer in patients with a history of severe colorectal disease.
Between 2002 and 2009, 14 patients with a history of severe colorectal disease (cancer, lymphoma, inflammatory bowel diseases [IBD]) were treated with HIFU as a primary care option for localized prostate cancer.
Mean age was 65.8 ± 6.1 years. Mean time between colorectal disease treatment and HIFU was 10.6 ± 6.8 years. The mean Prostate Specific Antigen (PSA) before HIFU was 12.1 ng/mL (4.5-55). Gleason score was inferior or equal to 6 in four patients (28.6%), equal to 7 in nine patients (64.3%) and superior or equal to 8 in one patient (7.1%). The mean prostate volume before HIFU was 22.1 ± 11.7 mL. The number of HIFU sessions per patient was 1.35. The mean nadir PSA was 0.61 ± 0.82 ng/mL. Systematic control biopsies were negative in seven patients (50%). Mean follow-up was 22 months with a 35.7% complication rate (three erectile dysfunctions, two urinary stress incontinences). No recto-urethral fistula occurred.
HIFU was an interesting therapy for patients with a history of colorectal disease for whom regular treatment was challenging or non feasible.

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Keywords

14 patients
 
35.7% complication rate
 
colorectal disease treatment
 
erectile dysfunctions
 
inflammatory bowel diseases [IBD]
 
localized prostate cancer
 
Mean age
 
Mean follow-up
 
mean nadir PSA
 
mean Prostate Specific Antigen
 
mean prostate volume
 
Mean time
 
non feasible
 
oncological outcomes
 
primary care option
 
prostate cancer
 
recto-urethral fistula
 
severe colorectal disease
 
Systematic control biopsies
 
urinary stress incontinences