Percutaneous prostate cryoablation as treatment for high-risk prostate cancer.
OBJECTIVE
To evaluate percutaneous cryotherapy as a primary treatment option for high-risk prostate cancer patients.


METHODS
From October 2000 to February 2005, 21 high-risk (Gleason e.8 and/or PSA > 10 and/or stage > T2a) prostate cancer patients underwent 24 percutaneous prostate cryoablation procedures. Patients' median age was 70.9, and the average pretreatment PSA was 19.5 ng/dL. The follow-up period ranged from 6 to 60 months (median, 41 months).


RESULTS
The PSA failure rate was 39%, 52.9%, and 42.8% at 12, 24, and 60 months of follow-up, respectively. Overall complication rates were low, with 8% of urinary incontinence and no cases of rectal injury; however, 96% of erectile dysfunction occurred. The cryoablation procedure failed in 12 patients (57.2%); 7 (58.3%) of these were local failures (positive prostate biopsies).


CONCLUSIONS
Percutaneous cryoablation of the prostate is a safe minimally invasive treatment, but it has poor PSA-free survival outcomes in high-risk prostate cancer patients.
El Hayek
Omar Reda
OR
Hospital das Clínicas, Medical School, São Paulo University, São Paulo, SP, Brazil. hayek@uol.com.br
Alfer
Wladimir
W
Reggio
Ernesto
E
Pompeo
Antonio Carlos L
AC
Arap
Sami
S
Srougi
Miguel
M
D000368:Aged; D000369:Aged, 80 and over; D003452:Cryosurgery / Q000379:methods*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000601:surgery*; D012306:Risk; D016879:Salvage Therapy / Q000379:methods*
D017430:Prostate-Specific Antigen