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“Cryotherapy for Localized PCa: Indications and Technique”
John S. Lam, MD and Arie S. Belldegrun, MD Urology Times, February 2005. Copyright © 2005 by Advanstar Communications Inc.
In this study 175 patients were
evaluated in a multicenter clinical trial. All underwent
cryotherapy using third-generation cryoneedles.
After a 12-month follow-up period, 80 out of 110 patients
(73%) remained with a PSA level less than .4ng/mL, while
32 of 45 (72%) high risk patients remained free from
biochemical progression. The rates of those who experienced
side effects were as follows; 6% had urethral sloughing,
4% had pelvic pain, and 3% had urinary retention. No
urinary rectal fistulas could be reported. Of 175, 29
patients underwent salvage cryoablation for radiation
failure. Cryotherapy
of the prostate seems to be effective in ridding the
body of primary and radioresistant
tumors with lower morbidity rates when compared to other
available treatments.
“Treatment of Organ Confined Prostate Cancer with Third Generation Cryosurgery: Preliminary Multicenter Experience”
Ken-Ryu Han, Jeff K. Cohen, Ralph J. Miller, Allan J. Pantuck, Danielo G. Freitas, Carlos A. Cuevas, Hyung L. Kim, James Lugg, Stacy J. Childs, Barry Shuman, Maury A. Jayson, Neal D. Shore, Yan Moore, Amnon Zisman, Joe Y. Lee, Roland Ugarte, Lance A. Mynderse, Torrence M. Wilson, Susan D. Sweat, Horst Zincke And Arie S. Belldegrun. | The Journal Of Urology® Vol. 170, 1126–1130, October 2003.Copyright © 2003 By American Urological Association
In this study physicians tracked
106 patients 12 months after they had received cryotherapy
using a brachytherapy template. Those that underwent
cryotherapy as first
line monotherapy experienced certain
complications including 5% with tissue sloughing, 3%
with incontinence
requiring pads, 5% with incontinence not requiring pads,
3.3% with urinary retention, and 2.6% with rectal discomfort.
Doctors did not report any cases of fistulas or infections.
In previously-potent patients, 87% were impotent
after surgery. Again no fistulas were reported in patients
who had received salvage
cryotherapy and only 2 required pads. Those with
a PSA nadir of 0.4ng/mL or less after 3 months were
96 (81%) of 106 patients. Out of the entire group, 79
patients (75%) remained free from biochemical recurrence
at 12 months. Forty-two low-risk patients (78%) out
of the 79 had a PSA less than or equal to 0.4ng/mL,
compared to 37 (71%) high-risk patients. Although long-term
effectiveness is yet to be determined, the use of ultrathin
needles through a brachytherapy template in cryosurgery
has valid potential.
“Prostate Cryoablation Using Direct Transperineal Placement of Ultrathin Probes Through a 17-Gauge Brachytherapy Template- Technique and Preliminary Results”
Amnon Zisman, Allan J. Pantuck, Jeffery K. Cohen, And Arie S. Belldegrun. UROLOGY 58: 988–993, 2001. © 2001, Elsevier Science Inc.
In this study 92 patients underwent
prostate cryoablation.
The procedures used ultraline probes guided by a 17-gauge
brachytherapy template attached to the perineum. Of
92, 71 patients received primary cryotherapy, 19 were
salvage procedures, and 2 were repeated cryoablations.
The results reported no fistulous or major complications.
Only 8 patients (8.3%) experienced minor side effects.
After adequate time had passed a PSA
nadir result could be determined in 36 patients. Those
with a PSA less than or equal to 0.5 consisted of 31
(86%), compared to 5 patients greater than 0.5ng/mL.
Within this study there lacks major complications when
compared to other published trials. Longer follow-up
data has yet to be revealed.
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