title: Cryoablation of localized prostate cancer. Experience in 48 cases, PSA and biopsy results.
abstract: OBJECTIVE
  As the first German center to perform perineal cryoablation of localized prostate cancer, we present our experience in a series of 48 consecutive patients.
  
  
  METHODS
  7 patients staged T1, 21 with T2 disease and 20 patients with T3 tumor were treated. 62.5% of the patients received neoadjuvant hormonal downsizing. Follow-up ranged from 4 to 27 months with a median of 15 +/- 5.7 months.
  
  
  RESULTS
  Positive control biopsies after 6 months were obtained in 0% of T1 tumors, 16.7% of T2 tumors and 26.7% of T3 tumors. Prostate-specific antigen persistence above 1 ng/ml was diagnosed in 14.3, 33.3, and 40%, respectively. Complications were acceptable. 22.9% of the patients had prolonged urinary retention, requiring transurethral resection in 5 patients (10.4%) to relieve obstruction. In 5 cases (10.4%) incontinence was found, in 2 of these patients mild urge incontinence declined over time, in 3 cases moderate to severe stress incontinence developed. Two of these patients were pretreated with radiotherapy. No fistulae were noted.
  
  
  CONCLUSIONS
  Cryoablation of the prostate is not a substitution for radical prostatectomy but enables the surgeon to perform a radical curative procedure in patients unfit for other radical forms of treatment or unwilling to undergo these. Long-term follow-up and prospective studies are necessary to define the clinical significance of this procedure.
authors.affiliation: Department of Urology, University of Cologne, Germany. p.derakhshani@uni-koeln.de
authors.forename: P
authors.initials: P
authors.lastname: Derakhshani
authors.forename: S
authors.initials: S
authors.lastname: Neubauer
authors.forename: M
authors.initials: M
authors.lastname: Braun
authors.forename: J
authors.initials: J
authors.lastname: Zumbé
authors.forename: A
authors.initials: A
authors.lastname: Heidenreich
authors.forename: U
authors.initials: U
authors.lastname: Engelmann
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D001707:Biopsy, Needle; D003452:Cryosurgery / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011183:Postoperative Complications; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*
chemical_list: D000726:Androgen Antagonists; D017430:Prostate-Specific Antigen