Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;26(1):88-95.
doi: 10.1038/s41391-022-00516-7. Epub 2022 Mar 5.

Prostate arterial chemoembolization for treatment of refractory hematuria and urinary retention in patients with localized advanced prostate cancer

Affiliations

Prostate arterial chemoembolization for treatment of refractory hematuria and urinary retention in patients with localized advanced prostate cancer

Mao Qiang Wang et al. Prostate Cancer Prostatic Dis. 2023 Mar.

Abstract

Objectives: To evaluate the safety and efficacy transcatheter arterial chemoembolization (TACE) for the treatment of refractory gross hematuria (RGH) and urinary retention (UR) secondary to localized advanced prostate cancer (PCa).

Patients and methods: Thirty-two patients (mean age 72.5 years, range 60-89) with advanced PCa-related RGH that failed conventional therapy were included. Twenty-two of these patients had catheter-dependent due to PCa-related UR. TACE was performed with epirubicin (EPI)-eluting HepaSpheres (HS) plus intra-arterial (IA) infusion of docetaxel. Technical success, adverse events (AEs), overall survival (OS), control of RGH, removal of indwelling catheters, and local disease control, were evaluated.

Results: Technical success was achieved in 100% without major AEs. Mean follow up post-TACE was 27 months (range 8-56 months) with a mean OS of 30 months. GRH stopped within 5 days after TACE in all patients, 26 (86.7%) of these patients exhibited good bleeding control during a mean follow-up of 24 months; 17 (77.3%) of the 22 patients with UR had recovered spontaneous urination, 15 (88.2%) patients were catheter-free at their last follow-up with a mean of 24 months. BS was obtained in 73.3% (22/30) of patients at a mean follow-up of 29 months. At the last visit, 22 patients had a mean of 36 months follow-up and the mean percentage reduction in prostate volume was 55.5%, with a statistically different from baseline (P = 0.022). Negative biopsy results were obtained in 84.2% (16/19) of the patients at 12-47 months after TACE. Compared with baseline values, there was a significant improvements in IPSS, QoL, Qmax, and PVR (all P < 0.05).

Conclusions: TACE using EPI-eluting HS plus IA infusion of docetaxel is a safe and effective treatment option for the advanced PCa patients with GRH and UR, and it could be considered as an alternative if there was no other therapeutic choice.

PubMed Disclaimer

References

    1. Gronberg H, Adolfsson J, Aly M, Nordström T, Wiklund P, Brandberg Y, et al. Prostate cancer screening in men aged 50–69 years (STHLM3): a prospective population-based diagnostic study. Lancet Oncol. 2015;16:1667–76. https://doi.org/10.1016/S1470-2045(15)00361-7 . - DOI - PubMed
    1. Sanda MG, Cadeddu JA, Kirkby E, Chen RC, Crispino T, Fontanarosa J, et al. Clinically localized prostate cancer: AUA/ASTRO/SUO guideline. part i: risk stratification, shared decision making, and care options. J Urol. 2018;199:683–90. https://doi.org/10.1016/j.juro.2017.11.095 . - DOI - PubMed
    1. van der Poel HG, van den Bergh RCN, Briers E, Cornford P, Govorov A, Henry AM, et al. Focal therapy in primary localised prostate cancer: The European Association of Urology Position in 2018. Eur Urol. 2018;74:84–91. https://doi.org/10.1016/j.eururo.2018.01.001 . - DOI - PubMed
    1. Avellino GJ, Bose S, Wang DS. Diagnosis and management of hematuria. Surg Clin North Am. 2016;96:503–15. https://doi.org/10.1016/j.suc.2016.02.007 . - DOI - PubMed
    1. Comploj E, Pycha A, Trenti E, Palermo S, Bonatti M, Krause P, et al. Transarterial embolization in the management of intractable haemorrhage. Urol Int. 2021;105:95–99. https://doi.org/10.1159/000511123 . - DOI - PubMed

Publication types

MeSH terms