X-RAY-GUIDED ENDOVASCULAR SURGERY IN PATIENTS WITH BENIGN PROSTATIC HYPERPLASIA AND PROSTATE CANCER
- Authors: Neimark A.I1, Tachalov M.A2, Neimark B.A1, Torbik D.V1, Arzamastsev D.D.3
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Affiliations:
- Altai State Medical University
- Clinical Hospital at Barnaul Railway Station of JSC «RZD»
- Altai Regional Clinical Hospital
- Issue: No 1 (2017)
- Pages: 54-60
- Section: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/286748
- DOI: https://doi.org/10.18565/urol.2017.1.54-60
- ID: 286748
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Abstract
Aim To evaluate the efficacy and safety of superselective embolization and chemoembolization of the prostatic artery as an independent method of treating prostate cancer and BPH. Materials and methods From 2004 to 2015, 116 patients with BPH (mean age 73.2±5.2 years) underwent prostatic artery embolization. Mean prostate volume ranged from 55 to 296 cc3. From 2011 to 2015, 37 patients with prostate cancer (mean age 72.3±2.06 years) were treated with X-ray-guided endovascular chemoembolization. All patients had confirmed PCa, of whom 7 had stage T2a and 30 stage T2c disease. PSA ranged from 0.8 to17 ng/ml (mean 13.1±3.9). Prostate volume ranged from 61 to 93 cc3 (mean 69.4±9.3). The follow-up ranged from 8 to 42 months. Results Prostatic artery embolization in BPH patients resulted in a significant reduction in IPSS symptom score and increase in Qmax. The volume of prostate and nodular mass decreased on average by 53% and 47%, respectively, maximum by 82%. Chemoembolization was effective in 31 (83.7%) patients. An objective response was achieved in reducing the PSA level and prostate volume measured by TRUS, and improved urination. The median PSA at 6 months was - 3.4 ± 0.02 ng/ ml. In all patients, chemoembolization resulted in a marked reduction in the prostate volume. The greatest decrease in the prostate volume was observed at 6 months after treatment. Chemoembolization led to a marked improvement in the quality of urination confirmed by uroflowmetry and IPSS symptom scores. At 12 months, 16 patients with prostate cancer underwent the follow-up biopsy. In 12 cases pathology showed fibrosis and epithelial degeneration without signs of atypia and in 2 cases curative pathomorphosis was observed. Chemoembolization was well tolerated and did not cause any significant complications. Conclusion Embolization techniques for BPH and chemoembolization for localized PCa showed good effectiveness and safety in patients who had medical contraindications to traditional treatments.
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About the authors
A. I Neimark
Altai State Medical University
Email: urologagmu@mail.ru
Dr.Med.Sci., Professor, Head of the Department of Specialized Surgery in Urology, Traumatology and Ophthalmology Barnaul, Russia
M. A Tachalov
Clinical Hospital at Barnaul Railway Station of JSC «RZD»
Email: med7@mail.ru
Urologist at the Department of Urology Barnaul, Russia
B. A Neimark
Altai State Medical University
Email: neimark.b@mail.ru
Dr.Med.Sci., Associate Professor, Professor at the Department of Specialized Surgery in Urology, Traumatology and Ophthalmology Barnaul, Russia
D. V Torbik
Altai State Medical University
Email: Demid.Tor@yandex.ru
PhD Student at the Department of Specialized Surgery in Urology, Traumatology and Ophthalmology Barnaul, Russia
D. D. Arzamastsev
Altai Regional Clinical Hospital
Email: floyd-76@mail.ru
PhD, Head of Department of Diagnostic and Interventional Radiology №2 Barnaul, Russia
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