Ganzer Roman, Bründl Johannes, Koch Daniel, Wieland Wolf F, Burger Maximilian, Blana Andreas
Department of Urology, University of Regensburg, Regensburg, Germany.
World J Urol. 2015 Jan;33(1):99-104. doi: 10.1007/s00345-014-1289-2. Epub 2014 Apr 3.
To determine which pretreatment clinical parameters were predictive of a low prostate-specific antigen (PSA) nadir following high-intensity focused ultrasound (HIFU) treatment.
Retrospective study of patients with clinically localised prostate cancer undergoing HIFU at a single centre between December 1997 and September 2009. Whole-gland treatment was applied. Patients also included if they had previously undergone transurethral resection of the prostate (TURP). TURP was also conducted simultaneously to HIFU. Biochemical failure based on Phoenix definition (PSA nadir + 2). Univariate and multivariate analysis of pretreatment clinical parameters conducted to assess those factors predictive of a PSA nadir ≤0.2 and >0.2 ng/ml.
Mean (SD) follow-up was 6.2 (2.8) years; median (range) was 6.3 (1.1-12.2) years. Kaplan-Meier estimate of biochemical disease-free survival rate at 8 years was 83 and 48 % for patients achieving a PSA nadir of ≤0.2 and >0.2 ng/ml, respectively. Prostate volume and incidental finding of cancer were significant predictors of low PSA nadir (≤0.2 ng/ml).
Prostate volume and incidental finding of cancer could be predictors for oncologic success of HIFU based on post-treatment PSA nadir.
确定哪些治疗前临床参数可预测高强度聚焦超声（HIFU）治疗后前列腺特异性抗原（PSA）的最低值较低。
对1997年12月至2009年9月在单一中心接受HIFU治疗的临床局限性前列腺癌患者进行回顾性研究。采用全腺治疗。如果患者先前接受过经尿道前列腺切除术（TURP），也将其纳入研究。TURP也可与HIFU同时进行。根据Phoenix定义（PSA最低值+2）判定生化失败。对治疗前临床参数进行单因素和多因素分析，以评估那些可预测PSA最低值≤0.2和>0.2 ng/ml的因素。
平均（标准差）随访时间为6.2（2.8）年；中位数（范围）为6.3（1.1 - 12.2）年。PSA最低值≤0.2和>0.2 ng/ml的患者8年时生化无病生存率的Kaplan-Meier估计值分别为83%和48%。前列腺体积和偶然发现的癌症是PSA最低值较低（≤0.2 ng/ml）的显著预测因素。
基于治疗后PSA最低值，前列腺体积和偶然发现的癌症可能是HIFU肿瘤学成功的预测因素。
