The gold standard for the treatment of prostate cancer in the world is now a laparoscopic or classical radical prostatectomy. However, some of the patients may be considered for other treatments, traumas or complications of which are gentler of known complications of surgery.
In well-designed studies concerning the results of treatment with different methods patients are matched pairs. This allows imaging in a comparative what are the possible benefits of each method in the range of parameters evaluated.
Comparison of HIFU method with prostatectomy, shows that HIFU is less radical, but it has more favorable results in treatment of local relapse with radiotherapy. What is particularly important, after 9 years of follow-up parameters for disease-free survival and metastasis free survival were similar for both methods 89%, 97%, 94% for HIFU and 89%, 97%, 97% for radical prostatectomy. (p=0.186, 0.3120.107).
Results of similar HIFU and extended beam radiotherapy (EBRT) study showed no statistically significant difference between survival without the disease progression (47% versus 52%, p=0.311). After five years the percentage of patients not requiring palliative hormonal treatment differed significantly (85% after HIFU versus 58% after EBRT, p=0.002).
After seven years of follow up, the parameters of survival specific for a disease and survival free of metastases were 87%, 100%, 100% for HIFU and 99%, 100%, 98% for EBRT (p = 0.043, 0.932, 0.941). There was no clinically significant difference in progression-free survival at 5 years after treatment between the two methods, and patients after treatment with radiotherapy significantly more likely required the inclusion of palliative hormonal treatment, than those treated using HIFU
These results were presented at the annual meeting of the American Urological Association in Orlando in 2014. Team of professor Sébastien Crouzet has been awarded the Best Poster of the whole multi-subject congress among the thousands of reported research results.
Comment made by Marek Filipek MD, PhD.
