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Prostatic Artery Embolization in the Treatment of Localized Prostate Cancer: A Bicentric Prospective Proof-of-Concept Study of 12 Patients

Journal Paper/Review - Mar 23, 2018

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Citation
Mordasini L, Hechelhammer L, Diener P, Diebold J, Mattei A, Engeler D, Muellhaupt G, Kim S, Schmid H, Abt D. Prostatic Artery Embolization in the Treatment of Localized Prostate Cancer: A Bicentric Prospective Proof-of-Concept Study of 12 Patients. J Vasc Interv Radiol 2018; 29:589-597.
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Journal Paper/Review (English)
Journal
J Vasc Interv Radiol 2018; 29
Publication Date
Mar 23, 2018
Issn Print
Issn Electronic
1535-7732
Pages
589-597
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Brief description/objective

PURPOSE
To provide initial data on tumoricidal efficacy of embolization on prostate cancer via histopathologic examination of prostatectomy specimens after embolization.

MATERIALS AND METHODS
In this bicentric prospective trial, 12 men with localized prostate cancer underwent radical prostatectomy 6 weeks after prostatic artery embolization (PAE) from October 2016 to May 2017. PAE was performed with the use of 100-μm Embozene microspheres (Boston Scientific, Natick, Massachusetts). Response of prostate cancer tissue to PAE was assessed according to tumor regression grades. The major outcome measure was complete histopathologic absence of viable cancer cells, including secondary foci, in the prostatectomy specimens.

RESULTS
Complete necrosis of the index lesion was found in 2 patients and partial necrosis in 5. Considering secondary cancerous foci, viable cancer cells were found in all 12 patients. Pathologic specimens were characterized by demarcated zones of necrotic tissue predominantly located in the central gland. Two patients required additional surgery to remove necrotic bladder tissue caused by PAE.

CONCLUSIONS
PAE with the use of 100-μm microspheres failed to achieve complete elimination of tumor cells. Extensive tumor regression was induced in some lesions, highlighting the need for further assessment of PAE as a potential treatment option for prostate cancer.