How to select patients for high-energy transurethral microwave thermotherapy

Objectives. To assist urologists in selecting patients for high-energy tran surethral microwave thermotherapy (TUMT) on the basis of baseline character istics. Methods. Two hundred forty-seven patients with lower urinary tract symptoms and benign prostatic hyperplasia were treated with high-energy TUMT using the Prostatron device, software version 2.5, To evaluate outcome at 26 week s, the World Health Organization response evaluation criteria were used. Mu ltiple logistic regression models were created to identify the predictive v alue of baseline parameters and total amount of energy used. In addition, r eceiver operating characteristic curve and the best cutoff point for the pr ediction of a good response of each criterion under the condition of equal "costs" of misclassification to cases and noncases were calculated, Results. For each of the three response evaluation criteria, graphs are pre sented to determine whether high-energy TUMT using the Prostatron can be ju stified, Only the total amount of energy delivered by the device has a majo r impact in all three criteria used. Conclusions. Graphs have been constructed from our analysis to assist urolo gists in making clinical recommendations for treatment on the basis of the expected outcome when using high-energy TU MT, UROLOGY 53: 111-117, 1999. ( C) 1999, Elsevier Science Inc. All rights reserved.