Robotic-assisted laparoscopic radical prostatectomy for treatment of a newly identified lesion revealed no viable cells in the previously treated area with microwave focal therapy

Q4 Medicine IJU Case Reports Pub Date : 2024-05-14 DOI:10.1002/iju5.12733

Fumio Tsukuda, Toshihiro Shimizu, Kiichi Hagiwara, Yoshiyuki Kawano, Noboru Sakamoto, Shingo Itagaki, Yutaka Horiguchi, Shoji Koga, Osamu Ukimura

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Abstract

Introduction

Histological outcome of the targeted focal therapy is in principle confirmed by targeted needle biopsy from the treated area in clinical trial. Herein, we report a rare case in which the MFT was followed by RARP.

Case presentation

A 68-year-old man with PSA 9.6 ng/mL and PI-RADS 4 lesion in the right transition zone on multi-parametric MRI underwent MR/ultrasound fusion-guided targeted biopsy, which revealed grade-group 1 cancer. Targeted focal therapy with microwave ablation was performed, resulting in disappearance of the PI-RADS 4 lesion at post-operative 4 months. However, PSA rose to 11.5 ng/mL, and a new PI-RADS 4 lesion, was identified in the left peripheral zone. RARP was performed to reveal new grade-group 3 cancer, and no viable cells in the previously treated area with MFT.

Conclusion

RARP was safely performed even after MFT and proved the pathological complete response of microwave ablation.

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用机器人辅助腹腔镜根治性前列腺切除术治疗新发现的病灶，发现之前用微波病灶疗法治疗过的区域没有存活细胞

在临床试验中，靶向病灶治疗的组织学结果原则上由治疗区域的靶向针刺活检来确认。一位 68 岁的男性患者 PSA 为 9.6 ng/mL，多参数磁共振成像显示右侧过渡区有 PI-RADS 4 级病变，在磁共振/超声融合引导下接受了靶向活检，结果显示为 1 级癌症。患者接受了微波消融的靶向病灶治疗，术后 4 个月，PI-RADS 4 级病灶消失。然而，PSA升至11.5纳克/毫升，并在左侧外周区发现了一个新的PI-RADS 4病灶。即使在微波消融术后，RARP 仍能安全进行，并证明了微波消融术的病理完全反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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