Radical prostatectomy after vascular targeted photodynamic therapy Tookad® Soluble: Feasability, short and long term results

32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

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Radical prostatectomy after vascular targeted photodynamic therapy Tookad® Soluble: Feasability, short and long term results Eur Urol Suppl 2017; 16(3);e2089

Pierrard V.1, Lebdai S.2, Terrier J.E.3, Azzouzi A-R.2, Kleinclauss F.4, Joniau S.5, Van Der Poel H.6, Salomon G.7, Casanova J.8, Medina R.9, Potiron E.10, Rigaud J.11, Barret E.12, Gaillac B.13, Ruffion A.3 1

Hospital Center Lyon Sud, Dept. of Urology, Lyon, France, 2Hospital Center, Dept. of Urology, Angers, France, 3Centre Hospitalier Lyon Sud, Dept. of Urology, Lyon, France, 4Hospital Center, Dept. of Urology, Besançon, France, 5Hospital Center, Dept. of Urology, Leuven, Belgium, 6Antoni Van Leeuwenhoek Hospital, Dept. of Urology, Amsterdam, The Netherlands, 7Spire Portsmouth Hospital, Dept. of Urology, Hamburg, Germany, 8Hospital Center, Dept. of Urology, Valencia, Spain, 9Hospital Center, Dept. of Urology, Sevilla, Spain, 10Clinique Atlantis, Dept. of Urology, Nantes, France, 11Centre Hospitalier, Dept. of Urology, Nantes, France, 12Institut Mutualiste Montsouris, Dept. of Urology, Paris, France, 13Institut STEBA, Dept. of Urology, Paris, France INTRODUCTION & OBJECTIVES: Focal therapy by vascular-targeted photodynamic therapy with TOOKAD® Soluble (VTP) is one of new alternatives with low morbidity to treat localized prostate cancer. The objective of this study is to investigate the feasability of prostatectomy after vascular targeted photodynamic therapy (VPT) and describe short and long term results. MATERIAL & METHODS: Between 2009 and 2016, 46 patients underwent prostatectomy after VPT in 13 surgical centers in Europa. We excluded 10 patients who had a functional follow up of less than 6 months. We retrospectively reported short terms outcomes: Median operation time, blood loss, nerve sparing, complications then oncological and functionnal outcomes with a median follow up of 21 months. RESULTS: Median age was 64 years (46- 78). Median delai between VPT and prostatectomy was 21 months (3-61). Median PSA before VPT was 5,5 ng/mL. Median operating time was 183 mn. Median blood loss was 270 mL. According to the surgeons, the surgery was easy for 17 patients, quite difficult for 7 patients, and difficult for 4 patients (tissues adherences). Bilateral nerve sparing was feasible for 15 patients, unilateraly for 2 patients. Median urethral catheterization was 8 days. Median hospital stay was 6 days. No peri operative mortality. 5 post operative complications (2 claviens I, 2 claviens I, 1 clavien III because of an ureteral injury). Exam of prostatectomy pieces showed: 13 pT 3, 22 pT2. Surgical margins were positive for 12 patients. PSA was indetectable at one year for 32 patients. The 4 other patients has indectectable PSA at 6 months (no data at 1 year). 5 patients had complementary radiotherapy. After a median follow up of 21 months, 65% of patients were completely continent, 32% had low incontinence. 12% recovered potency without treatment, 64% recovered potency with appropriate treatment. CONCLUSIONS: Salvage RP after VTP treatment was feasible to treat most of the locally recurrent prostate cancer. We think that the evaluation of the oncological and functional results of the surgery in the relapsing patients is very important. Indeed it will in the end help to assess the real place of this

Eur Urol Suppl 2017; 16(3);e2089

32nd Annual EAU Congress, 24-28 March 2017, London, United Kingdom

V40

Radical prostatectomy after vascular targeted photodynamic therapy Tookad® Soluble: Feasability, short and long term results Eur Urol Suppl 2017; 16(3);e2090

new and it seems "truly" mini invasive treatment.

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