Transrectal focused ultrasound combined with transurethral resection of the prostate for the treatment of localized prostate cancer: feasibility study.
Transrectal focused ultrasound combined with transurethral resection of the prostate for the treatment of localized prostate cancer: feasibility study.
复制标题
经直肠聚焦超声联合经尿道前列腺电切术治疗局限性前列腺癌：可行性研究。
作者：
G. Vallancien;D. Prapotnich;X. Cathelineau;H. Baumert;F. Rozet
目的
我们研究了高强度聚焦超声（HIFU）联合经尿道前列腺切除或切开治疗局限性前列腺癌的可行性，以降低治疗后长期尿潴留的风险。
材料和方法
本可行性研究纳入了30例符合特定标准的患者，即适用于HIFU的局限性前列腺癌，年龄≥ 60岁，前列腺体积≤ 45 cc，六分活检时阳性样本不超过4个，基线前列腺特异性抗原（PSA）≤ 10 ng/ml，无癌症扩展证据。他们在全身麻醉下使用Ablatherm HIFU设备（EDAP SA，里昂，法国）接受联合治疗。
结果
入组的患者平均年龄为72岁，前列腺体积中位数为30 cc。中位Gleason评分为6，中位PSA为7 ng/ml，治疗前六分活检提供了中位2份阳性样本。平均手术时间为2小时48分钟，包括切除和HIFU。平均进行了616次HIFU照射。治疗后第2天拔除导尿管。中位住院时间为3天。仅观察到少数并发症。关于肿瘤学方面，在平均20个月的随访中，86%的患者在HIFU后活检呈阴性。中位PSA为0.9 ng/ml。随访1年时，平均国际前列腺症状评分为8分。在性功能方面，73%的既往性功能强的患者报告性活动保留。
结论
内镜下前列腺切除术或切开术与HIFU治疗相结合，可减少导尿时间，改善治疗后排尿状态，且无额外发病率。
PURPOSE
We studied the feasibility of combined treatment with high intensity focused ultrasound (HIFU) and transurethral resection or incision of the prostate for localized prostate cancer to decrease the risk of posttreatment prolonged urinary retention.
MATERIALS AND METHODS
Included in this feasibility study were 30 patients fulfilling certain criteria, namely localized prostate cancer indicated for HIFU, age 60 years or older, prostate volume 45 cc or less, no more than 4 positive samples at sextant biopsy, baseline prostate specific antigen (PSA) 10 ng/ml or less and no evidence of cancer extension. They received the combined treatment under general anesthesia using an Ablatherm HIFU device (EDAP SA, Lyon, France).
RESULTS
The enrolled patients were a mean of 72 years old and presented with a median prostate volume of 30 cc. Median Gleason score was 6, median PSA was 7 ng/ml and pretreatment sextant biopsies provided a median of 2 positive samples. Mean operative time was 2 hours 48 minutes, including resection and HIFU. An average of 616 HIFU shots were delivered. The urinary catheter was removed at day 2 after treatment. Median hospital stay was 3 days. Only a few complications were observed. In regard to the oncological aspects at a mean of 20 months of followup 86% of the patients had negative biopsies after HIFU. Median PSA was 0.9 ng/ml. At 1 year of followup the mean International Prostate Symptom Score was 8. Regarding sexual function, 73% of previously potent patients reported preserved sexual activity.
CONCLUSIONS
The combination of endoscopic resection or incision of the prostate with HIFU treatment decreases urinary catheterization time and improves posttreatment urinary status without additional morbidity.
影响因子：
2.9
作者：
F. Lizzi;M. Ostromogilsky
通讯作者：
F. Lizzi;M. Ostromogilsky