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“Selection of Salvage Crotherapy Patients”
Aaron E. Katz, MD, Mohamed A. Ghafar, MD Rev Urol. 2002;4(suppl 2):S18-S23.
In this study all patients had localized
prostate
cancer proven through a biopsy and received hormone
therapy for 3 months prior to cryotherapy using
the Cryocare unit. Doctors followed up with their patients
approximately 21 months after this minimally invasive
surgery. Of the patients, 65% remained free of biochemical
recurrence after 3 three years. With the use of the
external sphincter thermocouple, urinary incontinence
rates have dropped to 5% and below. Rectal fistula is
near 0%. These results indicate that salvage
cryotherapy guided by ultrasound monitoring may
prove beneficial to patients with recurrent localized
prostate cancer after radiation
therapy. As the technique is refined more effective
results take place.
“Salvage Cryotherapy for Recurrent Prostate Cancer After Radiation Therapy: The Columbia Experience”
Alexandre De La Taille, Omar Hayek, Mitchell C. Benson, Emilia Bagiella, Carl A. Olsson, Marie Fatal, And Aaron E. Katz. UROLOGY 55: 79–84, 2000. © 2000, Elsevier Science Inc.
During this study 43 patients with
biopsy proven recurrent prostate cancer underwent salvage
cryoablation between October 1994 and April 1999. Physicians
tracked their outcomes at 21.9 months. Prior to this
treatment all patients received 3 months of combined
hormone therapy. External-beam radiation therapy
was administered at least 18 months before an evaluation
took place to determine which patients were eligible.
Postoperatively some complications occurred including
incontinence (9%), obstruction (5%), urethral stricture
(5%), rectal pain (26%), urinary infection (9%), scrotal
edema (12%), and hematuria (5%). Patients whose PSA
level was less than .1 consisted of 26 (60%), 16 (37%)
had a PSA less than 4, and 1 (3%) had less than 10.
After 6 months 79% experienced biochemical
recurrence-free survival and at 12
months this rate remained at 66%.
“Cryotherapy for PCa: The Next Generation Innovative Biofeedback Applications in Urology”
John S. Lam, M.D., Oleg Shvarts, M.D., and Arie S. Belldegrun, M.D. Contemporary Urology, October 2004, Vol. 16, No. 10, 2-12
Many patients are often left with
the option of salvage cryotherapy after failures in
salvage prostatectomy,
brachytherapy,
or radiotherapy
are realized. In a study of 29 patients who had undergone
salvage cryotherapy at UCLA using the SeedNet system,
complications were minimal. All patients received a
biopsy proven recurrence without metastasis and after
12 months 13 of 18 (72%) have maintained a PSA of .4ng/mL
or less. Dr. Katz reported on a 6-year outcome with
67 salvage cryotherapy patients, using multiple thermocouples
and 3 months hormone therapy prior to the procedure.
Out of 67, 48 (72%) remained free of biochemical recurrence
after 12 months. Dr. Chin and associates identified
only 3.1% with persistent disease remaining with the
use of an argon-based
system in 118 patients. In 114 with a PSA
nadir less than .5ng/mL, 34% showed
no biochemical evidence of disease after 18 months.
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