Prostate cryoablation: prospective analysis comparing high- and low-risk prostate cancer outcomes.
OBJECTIVE
To evaluate percutaneous cryotherapy as a primary treatment option for prostate cancer, comparing different risk groups.


METHODS
Forty-seven prostate cryoablation procedures were performed on 44 patients. Patients median age was 70.9, and average pretreatment PSA of 13.8 ng/dl. Patients were divided into low-risk (13 patients), high-risk (24 patients) and radiation failure patients (7 patients). The follow-up period ranged from 18 to 60 months (median 41 months).


RESULTS
In the low-risk group, we found after 12 and 24 months of follow-up, 92 and 86% of patients free of PSA relapse (PSA <1 ng/ml), respectively. In the high-risk group, the PSA failure was 39 and 52.9%. For the radiation failure group, 86 and 71.4% of patients had PSA below 1 ng/dl. At 48 months of follow-up, 80% of the low-risk patients, 42.8% of the high-risk group and 71.4% of the radiation failure group were free of PSA relapse. The complication rates were low, with 13% of urinary incontinence and no cases of rectal injury.


CONCLUSIONS
Prostate cryoablation is a viable and promising minimally invasive alternative for localized or locally advanced prostate cancer patients.
El Hayek
Omar R
OR
Divisão de Clínica Urológica, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. hayek@uol.com.br
Alfer
Wladimir
W
Reggio
Ernesto
E
Pompeo
Antonio Carlos L
AC
Arap
Sami
S
Lucon
Antonio Marmo
AM
Srougi
Miguel
M