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Master Thesis

Résultats oncologiques et fonctionnels du traitement focal du cancer de la prostate localisé de risque faible et intermédiaire par HIFU : étude rétrospective bicentrique internationale

Abstract : Introduction: focal therapy using HIFU is developing with the objective of treating some localized prostate cancers, with lower morbidity compared to radical treatments. Methods: this is a retrospective, international, multicenter study. The patients selected benefit of treatment using HIFU FocalOne® between November 2014 and December 2019. The exclusion criteria were: an N + or M + stage, a previous treatment by radiotherapy or androgen deprivation therapy, treatment of more than 50% of the gland, ISUP>3, and a follow-up fewer than 12 months. The primary endpoint was the prevalence of retreatment. Results: 137 patients were included, with a median follow-up of 24 months. Median age was 63 years, mean PSA was 6.99ng/mL, median prostate volume was 49cc, stage T2a was predominant (48.8%), ISUP2 score also (45,3%) with 18.2% of ISUP3. 38.7% of treatments were an hemi-ablation, 61,3% were focal treatments. 76.6% of patients had control biopsies. 21.8% were positive for significant prostate cancer (ISUP>1) The retreatment rate was 37.9% including 31.4% of radical treatments. The 24-month retreatment-free survival was 74%. Logistic regression did not find any predictive factor for retreatment. The subgroup analyzes found significantly better survival without retreatment in patients with an initial PSA <8ng/mL, an ISUP1 score compared to those with an ISUP2 score (p<0.05) and a very marked trend in patients treated on more than 30% of the prostate volume (p=0,06). Grade 3 complications rate was 9,4%. Discussion: our results, both oncologically and functionally, are relatively consistent with the current literature. Median follow-up is too short to assess long-term oncology results. Including patients in follow-up cohorts, clinical trials, is necessary to specify the indications of focal treatment in localized prostate cancer.
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https://dumas.ccsd.cnrs.fr/dumas-03376556
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Submitted on : Wednesday, October 13, 2021 - 3:32:27 PM
Last modification on : Tuesday, November 23, 2021 - 3:15:42 AM
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Candice Debard, Eugénie, Léontine. Résultats oncologiques et fonctionnels du traitement focal du cancer de la prostate localisé de risque faible et intermédiaire par HIFU : étude rétrospective bicentrique internationale. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03376556⟩

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