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Partial prostatectomy - comments Arnulf Stenzl, Dep. of Urology, University Medical Center Tübingen, Germany FOIU, Tel Aviv, July 3, 2018

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Page 1: HIFU - Comtecgroup · Initial presentation Index genomic alterations Primary tumor Lymph node metastasis (obtained at RRP) Clonal selection : Time RRP Tumor progression Additional

Partial prostatectomy - comments

Arnulf Stenzl, Dep. of Urology, University Medical Center Tübingen, Germany

FOIU, Tel Aviv, July 3, 2018

Page 2: HIFU - Comtecgroup · Initial presentation Index genomic alterations Primary tumor Lymph node metastasis (obtained at RRP) Clonal selection : Time RRP Tumor progression Additional

Competing mortality

CaP

CaP

Watchful waiting

Radical prostatectomy

RPE vs. watchful waiting in men aged 65+ years

(SEER, n=44.694)

Abdollah et al., Eur Urol 2011

All p<0.001

Competing mortality

Page 3: HIFU - Comtecgroup · Initial presentation Index genomic alterations Primary tumor Lymph node metastasis (obtained at RRP) Clonal selection : Time RRP Tumor progression Additional

Role of multifocality in partial Px: size and location matters

HIF

U

Page 4: HIFU - Comtecgroup · Initial presentation Index genomic alterations Primary tumor Lymph node metastasis (obtained at RRP) Clonal selection : Time RRP Tumor progression Additional

a

*

**

b

c d

*

**

* *

** **

S. Kaufmann et al, under review, 2018

Page 5: HIFU - Comtecgroup · Initial presentation Index genomic alterations Primary tumor Lymph node metastasis (obtained at RRP) Clonal selection : Time RRP Tumor progression Additional

Haffner et al, J Clin Invest, 123(11):4918-4922, 2013

… but not always

Page 6: HIFU - Comtecgroup · Initial presentation Index genomic alterations Primary tumor Lymph node metastasis (obtained at RRP) Clonal selection : Time RRP Tumor progression Additional