[show abstract][hide abstract] ABSTRACT: ObjectiveTreatment of carcinoma of the prostate (CaP) begs some complex questions. Different disease stages call for different treatment modalities and no universally ‘gold standard’ treatment has yet been agreed upon. In the present work we will present the results, indications and limitations of HIFU in the treatment of CaP.MethodsRelevant information on HIFU treatment was identified through a literature search of published studies and review articles.ResultsHIFU can be considered for patients with (recurrent) localized CaP and a prostate volume of 40 cc or failure after radiotherapy. Treatment outcome is evaluated with PSA measurements and prostate biopsies. Mid-term follow up (2–5 years) reveals a PSA of 0.15 ng/ml and in 85% of cases the PSA level remains at the post HIFU nadir. The negative control biopsies are found in 90% of patients. A combination with a TURP reduces the treatment related morbidity.ConclusionsHIFU has proven mid-term high local and biochemical efficacy in patients with local confined prostate cancer. A HIFU also shows promising results in local recurrence of prostate cancer after external beam radiation.
[show abstract][hide abstract] ABSTRACT: Different treatment modalities are considered in treating locally advanced prostate cancer in men. This review discusses the long-term follow-up data of patients who underwent radical prostatectomy with or without adjuvant therapy. The value of an (extended) pelvic lymphadenectomy in these patients is also discussed.
Relevant information was identified through a literature search of published studies and review articles.
Radical prostatectomy alone in locally advanced prostate cancer seems to produce acceptable results. A nerve-preserving procedure in these patients, however, is not an option. Pretreatment with hormonal therapy does not seem to result in prolonged, progression-free or disease-specific survival. Adjuvant therapy after surgery seems to provide good survival rates.
Although no guidelines exist for the treatment of high-risk prostate cancer patients, real benefit seems to occur from radical prostatectomy to control the local tumor and prevent morbidity associated with tumor growth. Since studies clearly demonstrated the benefits of adjuvant therapy along with radical prostatectomy, this should be the preferred course of action.
The Canadian Journal of Urology 07/2005; 12 Suppl 2:33-7. · 0.74 Impact Factor