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Tytuł pozycji:

Pair-matched patient-reported quality of life and early oncological control following focal irreversible electroporation versus robot-assisted radical prostatectomy.

Tytuł :
Pair-matched patient-reported quality of life and early oncological control following focal irreversible electroporation versus robot-assisted radical prostatectomy.
Autorzy :
Scheltema MJ; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia. .; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia. .; Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. .
Chang JI; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.
Böhm M; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.
van den Bos W; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.
Blazevski A; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.
Gielchinsky I; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.
Kalsbeek AMF; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.
van Leeuwen PJ; Erasmus Medical Center, University of Rotterdam, Rotterdam, The Netherlands.
Nguyen TV; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; UNSW, Sydney, NSW, Australia.; School of Biomedical Engineering, University of Technology, Sydney, Australia.
de Reijke TM; Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Siriwardana AR; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.; UNSW, Sydney, NSW, Australia.
Thompson JE; Garvan Institute of Medical Research & The Kinghorn Cancer Centre, 370 Victoria Street, Sydney, NSW, 2010, Australia.; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.
de la Rosette JJ; Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Stricker PD; St Vincent's Prostate Cancer Centre, Sydney, NSW, Australia.
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Źródło :
World journal of urology [World J Urol] 2018 Sep; Vol. 36 (9), pp. 1383-1389. Date of Electronic Publication: 2018 Mar 28.
Typ publikacji :
Journal Article
Język :
English
Imprint Name(s) :
Original Publication: [Berlin ; New York] : Springer International, 1983-
MeSH Terms :
Quality of Life*
Robotic Surgical Procedures*
Electroporation/*methods
Prostatectomy/*methods
Prostatic Neoplasms/*surgery
Aged ; Humans ; Male ; Matched-Pair Analysis ; Middle Aged ; Organ Sparing Treatments ; Patient Reported Outcome Measures ; Propensity Score ; Prospective Studies ; Randomized Controlled Trials as Topic ; Treatment Outcome
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Contributed Indexing :
Keywords: Focal therapy; Irreversible electroporation; Prostate cancer; Radical prostatectomy; Robotic
Entry Date(s) :
Date Created: 20180330 Date Completed: 20190318 Latest Revision: 20190318
Update Code :
20201218
PubMed Central ID :
PMC6105143
DOI :
10.1007/s00345-018-2281-z
PMID :
29594551
Czasopismo naukowe
Purpose: The design, conduct and completion of randomized trials for curative prostate cancer (PCa) treatments are challenging. To evaluate the effect of robot-assisted radical prostatectomy (RARP) versus focal irreversible electroporation (IRE) on patient-reported quality of life (QoL) and early oncological control using propensity-scored matching.
Methods: Patients with T1c-cT2b significant PCa (high-volume ISUP 1 or any 2/3) who received unifocal IRE were pair-matched to patients who received nerve-sparing RARP. Patient-reported outcomes were prospectively assessed using the Expanded Prostate Cancer Index Composite (EPIC), AUA symptom score and Short Form of Health Survey (SF-12) physical and mental components. Oncological failure was defined as biochemical recurrence (RARP) or positive follow-up biopsies (IRE). Generalized mixed-effect models were used to compare IRE and RARP.
Results: 50 IRE patients were matched to 50 RARP patients by propensity score. IRE was significantly superior to RARP in preserving pad-free continence (UC) and erections sufficient for intercourse (ESI). The absolute differences were 44, 21, 13, 14% for UC and 32, 46, 27, 22% for ESI at 1.5, 3, 6, and 12 months, respectively. The EPIC summary scores showed no statistically significant differences. Urinary symptoms were reduced for IRE and RARP patients at 12 months, although IRE patient initially had more complaints. IRE patients experienced more early oncological failure than RARP patients.
Conclusions: These data demonstrated the superior preservation of UC and ESI with IRE compared to RARP up to 12 months after treatment. Long-term oncological data are warranted to provide ultimate proof for or against focal therapy.

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