Local recurrence of prostate cancer in patients after radical prostatectomy. Modern methods of diagnosis and treatment (contrast-enhanced endorectal magnetic resonance imaging, hystoscanning, hifu)


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Purpose. Improvement of the diagnosis and treatment in patients with prostate cancer. Materials and methods. The study included 54 patients with newly diagnosed BR after radical prostatectomy who underwent contrast-enhanced magnetic resonance imaging (endorectal coil 1.5 T) and hystoscanning. Local recurrence in 34 patients was morphologically confirmed by transrectal biopsy of VUA area. Results. 54 patients underwent HIFU treatment of local recurrence after radical prostatectomy in the Clinic of Urology of the First MSMU n.a. I.M. Sechenov for the period from October 2004 to February 2014. Prostate volume before RPE ranged from 21 to 102 cm 3. The median age was 62 years old, the minimum age of the patient was 46 years old, maximum age - 68 years. PSA levels before a HIFU sessions ranged from 0.4 to 18 ng/ml. Nadir PSA was 0.1 ng/ml and less after a 3-month follow-up. 5-year disease-free survival in patients with locally recurrent prostate cancer after HIFU (n = 54): in the group of low-risk prostate cancer, n = 14 (9і%), moderate-risk, n = 20 (84%), and high-risk, n = 20 (7і%). Conclusions. Contrast-enhanced magnetic resonance imaging (endorecal coil) is a highly informative method of diagnosis of local recurrence after radical prostatectomy, with specificity 64%, and sensitivity 96%; in the treatment process, HIFU is categorized as highly effective method of treatment.

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