Prognostic role of the biomolecular, morphological and clinical markers in the assessment of the efficacy of the treatment for localized prostate cancer using high-intensity focused ultrasound

Aim of the study: to evaluate the role of the prognostic factors in the efficacy control of the treatment for localized prostate cancer using high-intensity focused ultrasound (HIFU). Materials and methods: as the object of study the patients with biopsy-proven localized prostate cancer were chosen, which were treated using HIFU-ablation. Random assignment to two groups was performed: patients with or without confirmed local recurrence according to the prostate biopsy results after HIFU-ablation. Results. The most powerful predictors of the recurrence were serum PSA level, PSA-density, Gleason grade, presence of lymphovascular and perineural invasion. In our opinion next to these criteria it is necessary to use the immunohistochemistry markers using several antibodies. The most objective predictors of the favorable outcome were: PCNA expression up to Hs=160, low or negative expression of AMACR, low cytoplasmatic expression of bcl2, nuclear expression of p53 more than 120. Patients with extensive expression of the markers PCNA, AMACR and bcl2, low expression of the p53 and reduced expression of E-Cadherin could be identified as at risk of recurrence or the prolonged growth of the tumor not taking into consideration favorable clinical course of the disease. This information could be also used to decide, whether if these patient are in need of the additional treatment modalities or not.