title: Prostate cancer: US-guided percutaneous cryoablation. Work in progress.
abstract: OBJECTIVE
  To present early results of cryosurgical ablation of prostate cancer with an ultrasound-guided percutaneous technique.
  
  
  METHODS
  Cryosurgery was performed in 210 patients; near complete 3- and 6-month follow-up data were available for 130. Androgen ablation therapy was used to decrease the size of the prostate gland for optimal freezing. Prostate-specific antigen (PSA) and prostatic biopsy studies were performed at 3, 6, and 12 months.
  
  
  RESULTS
  Gland volume decreased from 29 cm3 +/- 14.1 to 20.4 cm3 +/- 8.4 (P < .0001) after androgen ablation. Rates of positive biopsy findings at 3, 6, and 12 months were 7.7%, 3.3%, and 2.3%, respectively. Serious complications were minimal and included no deaths, urethrorectal fistulas in five patients, and total incontinence in three. Mean PSA levels decreased from 12.6 +/- 16.1 preoperatively to 0.35 +/- 0.75 at 3 months, 0.54 +/- 1.1 at 6 months, and 0.43 +/- 0.78 at 12 months (persistent cancers excluded).
  
  
  CONCLUSIONS
  These preliminary results demonstrate that cryosurgery can cause necrosis of prostate cancer. Long-term results and randomized trials are necessary to determine if this means longer disease-free intervals and increased patient survival compared with results of current therapeutic methods.
authors.affiliation: Department of Radiology, Crittenton Hospital, Rochester, MI 48307.
authors.forename: D K
authors.initials: DK
authors.lastname: Bahn
authors.forename: F
authors.initials: F
authors.lastname: Lee
authors.forename: M H
authors.initials: MH
authors.lastname: Solomon
authors.forename: H
authors.initials: H
authors.lastname: Gontina
authors.forename: D L
authors.initials: DL
authors.lastname: Klionsky
authors.forename: F T
authors.initials: FT
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011677:Punctures; D017211:Treatment Failure; D018084:Ultrasonography, Interventional
chemical_list: D017430:Prostate-Specific Antigen