Cryosurgical ablation of the prostate: 5-year follow-up of a prospective study.
OBJECTIVE
To study the complications and oncological outcome after cryosurgical ablation of the prostate (CSAP).


METHODS
Fifty-four patients with prostate cancer were entered into this prospective phase II trial of CSAP. Patients were followed with serum PSA determinations, follow-up biopsies at 3-6 months postoperatively and a questionnaire to assess complications. A PSA of >1 ng/ml or a positive biopsy was interpreted as progression.


RESULTS
Mean follow-up was 58.5 months. Patients needed a suprapubic catheter postoperatively for in mean 18 days. Transient penile numbness occurred in 15%. Bothersome sloughing of dead tissue was noticed by 15% of patients and 15% needed a transurethral resection. Nine patients (17%) developed strictures and five patients stone formation in the prostatic urethra. One patient developed a perennial fistula. Thirty-nine out of 43 patients reporting on potency become impotent, nine patients developed a slight stress incontinence and one severe incontinence.At median follow-up, the actuarial progression-free survival was 38.9%. Fourteen out of 50 patients biopsied (28%) had remaining cancer in their prostates.


CONCLUSIONS
High complication rates in combination with poor oncological outcome has made us stop using this treatment modality.
Aus
Gunnar
G
Department of Urology, Sahlgrenska University Hospital, S-41345, Göteborg, Sweden. gunnar.aus@vgregion.se
Pileblad
Erik
E
Hugosson
Jonas
J
D000206:Actuarial Analysis; D000368:Aged; D003452:Cryosurgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen