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Palliative Prostate Artery Embolization for Prostate Cancer: A Case Series

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IntroductionProstate artery embolization (PAE) is recognized as a treatment for lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia. LUTS and urinary retention are common in men with… Click to show full abstract

IntroductionProstate artery embolization (PAE) is recognized as a treatment for lower urinary tract symptoms (LUTS) in men with benign prostatic hyperplasia. LUTS and urinary retention are common in men with prostate cancer (PCa). The purpose of this study was to estimate the efficacy and safety of palliative PAE on LUTS or urinary retention in men with advanced PCa.Materials and methodsThis prospective, single-center trial was conducted from March 2017 to November 2018. The trial protocol was registered online (ClinicalTrials.gov Identifier: NCT03104907). Only men with advanced PCa suffering from LUTS or urinary retention were included. The primary outcome was the ability to void without a catheter and International Prostate Symptom Score (IPSS) in non-catheter-dependent patients. The paired t test was used to analyze changes from baseline with 95% confidence intervals (CI). A p value < 0.05 was considered statistically significant.ResultsSeventeen patients were assessed for eligibility, and 15 patients with a mean age of 73.8 years were enrolled. Four men did not complete follow-up: cancer-related death (n = 2), lost to follow-up (n = 1), and unsuccessful embolization due to severe atherosclerosis (n = 1). Bilateral embolization was achieved in ten cases, and urinary retention resolved in one of six patients. LUTS improved in the remaining (n = 5) patients by a mean 12.2-point reduction in IPSS (95% CI − 23.53; − 0.87). According to the CIRSE classification, two grade 1 and two grade 3 complications occurred.ConclusionIn this study, palliative PAE was safe and efficient for treatment for LUTS associated with PCa.Level of EvidenceLevel 4, Case Series.Trial registration ClinicalTrials.gov Identifier: NCT03104907.

Keywords: artery embolization; urinary retention; prostate cancer; embolization; cancer

Journal Title: CardioVascular and Interventional Radiology
Year Published: 2019

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