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This abstract was presented during the past 27th Annual Congress of the European Association of Urology
Type: Poster Session
Session: HIFU, cryotherapy and androgen deprivation therapy
Date: Monday February 27, 2012 from 14:00 to 15:30
Room: Room Concorde Neuilly - Level 4
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Robotic high intensity focused ultrasound at 3 MHz, in localized prostate cancer: Side effects of 704 patients within 10 years
Thüroff, S.F.M.1, Chaussy, C.G.2
1Klinikum Harlaching, Dept. of Urology, Munich, Germany, 2University of Regensburg, Dept. of Urology, Munich/Regensburg, Germany
Introduction & Objectives

1st, to analyze the overall side effects of combined TUR and HIFU as definitive therapy of localised prostate cancer (PCa). 2nd to analyze the influence of 3 different current therapeutic strategies in HIFU therapy, as there are “HIFU only”, “TUR and HIFU in one session” and “TUR one month before HIFU” and 3rd to evaluate relative influence of neoadjuvant TUR on side effects.

Material & Methods

Prospective monocentric “Harlaching HIFU Database” (n=2.388, since 96) as data source for analysis. 3 patient cohorts (T1-2, N0, M0): are analyzed:
A) `98-00 (-HIFU only-), B) `01-04: (TUR&HIFU), C) `05-10: (TUR 1 month before HIFU): all patients without any previous PCa/PSA influencing therapy, treated completely by Ablatherm ® (robotic HIFU at 3 MHz, EDAP-Lyon-France).
Analysis of peri-and postoperative side effects as for the 3 consecutive cohorts.

Results

In a median follow up time of 5.5 years, side effects were registered. Further on, possible side effects which never occurred were identified to display the range,
timing and profile of TUR&HFU related side effect.

Rate of side effectsPrototypeMaxisIntegrated imaging
 96-992000-2004since 2005
n170358176
Incontinence < 3 months (%)4.24.23.1
Incontinence > 3 months (%)5.13.11.5
Recto-urethral fistula (%)0.420.230.0
Urinary tract infections (%)2.51.873.08
Perineal discomfort (%)1.260.230.51
Others perioperative (%)11.71.172.56
2nd endouro intervention (%)241924
Others in follow up (%)1.260.00.0
Conclusions

Side effect profile showed a low number of severe side effects TUR did not decrease the overall side effect rate. ¼ of the patients needed 2nd endourological intervention in follow up. The spectrum of “potentially side effects, which never occurred” showed the low invasiveness of the procedure. Source of Funding: Harlachinger Krebshilfe e.V. and Lingen foundation Thanks to Mrs. Regina Nanieva for HIFU database management.

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