Comprehensive Evaluation of Focal Therapy Complications in Prostate Cancer: A Standardized Methodology
Autor: | Fabio Muttin, Paolo Dell'Oglio, François Rozet, Arnas Bakavicius, Rafael Sanchez-Salas, Annick Mombet, Dominique Prapotnich, Xavier Cathelineau, Arjun Sivaraman, Eric Barret, Nathalie Cathala |
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Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Time Factors Multivariate analysis Urology medicine.medical_treatment 030232 urology & nephrology Cryotherapy Postoperative Hemorrhage Cryosurgery 03 medical and health sciences Prostate cancer Postoperative Complications 0302 clinical medicine Prostate Dysuria medicine Humans Ultrasound High-Intensity Focused Transrectal Aged Hematuria Retrospective Studies Epididymitis Hematoma Pain Postoperative business.industry Urinary retention Incidence Incidence (epidemiology) Prostatic Neoplasms Organ Size Hemospermia Middle Aged Prostate-Specific Antigen Urinary Retention medicine.disease Focal therapy Treatment Outcome medicine.anatomical_structure 030220 oncology & carcinogenesis Urinary Tract Infections Radiology medicine.symptom Urinary Catheterization business |
Zdroj: | Journal of Endourology. 33:509-515 |
ISSN: | 1557-900X 0892-7790 |
Popis: | Purpose: Today, up to one-third of newly diagnosed prostate cancer (PCa) cases may be suitable for focal treatment. The lack of data about the toxicity profiles of lesion-targeting therapies, however, has made it difficult to compare treatment modalities. The aim of the present study was to evaluate comprehensively the incidence, severity, and timing of onset of complications for PCa patients undergoing focal high-intensity focused ultrasound (HIFU) and focal cryosurgical ablation of the prostate (CSAP). Materials and Methods: A total of 336 patients were included who underwent focal HIFU or focal CSAP as a primary treatment for PCa between January 2009 and December 2017. Mean follow-up was 11 months (standard deviation: 3.0). All complications were captured and graded according to severity, and classified by timing of onset. Univariate and multivariate analysis was performed to identify predictors of the most common side effects. Results: There were 98 complications in 79/210 patients (38%) undergoing focal HIFU and 34 complications in 27/126 patients (21%) undergoing focal CSAP. In terms of severity, 95% of the complications of focal HIFU and 91% of the complications of focal CSAP were minor. Most complications presented in the early postoperative period. On multivariate analysis, subtotal HIFU was associated with acute urinary retention (AUR), while a smaller prostate size and longer catheterization time with dysuria. In CSAP patients, longer catheterization time was associated with AUR and urethral sloughing. The main limitation is the nonrandomized and retrospective nature. Conclusions: Focal HIFU and focal CSAP provide a tolerable toxicity, with primarily minor complications presenting in the early postoperative period. |
Databáze: | OpenAIRE |
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