title: Initial brazilian experience in the treatment of localized prostate cancer using a new generation cryotechnology: feasibility study.
abstract: BACKGROUND
  The objective of our study is to present the first Brazilian cryoablation experience in the treatment of low and intermediate risk localized prostate cancer using 3rd generation cryoablation and real-time biplanar transrectal ultrasonography.
  
  
  METHODS
  Ten Brazilian patients underwent primary cryoablation for localized prostate cancer between October 2010 and June 2011. All patients consented for whole gland primary cryotherapy. The procedures were performed by 3rd generation cryoablation with the Cryocare System ® (Endocare, Irvine, California). Preoperative data collection included patient demographics along with prostate gland size, Gleason score, serum prostate specific antigen, and erectile function status. Operative and post--operative assessment involved estimated blood loss, operative time, complications, serum PSA level, erectile function status, urinary incontinence, biochemical disease free survival (BDFS), and follow-up time.
  
  
  RESULTS
  All patients in the study successfully underwent whole gland cryoablation. The mean of: age, prostate size, PSA level, and Gleason score, was 66.2 years old; 40.7 g; 7.8 ng/mL; and 6 respectively. All patients were classified as low or moderate D' Amico risk (5 low and 5 moderate). Erectile dysfunction was present in 50% of patients. The estimated blood loss was minimal, operative time was 46.1 minutes. All patients that developed erectile dysfunction post-treatment responded to oral or intracavernosal medications with early penile rehabilitation. All patients maintained urinary continence by the end of a 10 months evaluation period and none had biochemical relapse within the mean follow-up of 13 months (7-15 months).
  
  
  CONCLUSIONS
  Our initial experience shows that cryoablation is a minimally invasive option for the treatment of localized prostate cancer. Short term data seems to be promising but longer follow-up is necessary to verify oncological and functional results.
authors.affiliation: Denver Health Medical Center, Denver, Colorado, USA. Fernando.Kim@dhha.org
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Kim
authors.forename: Michael A
authors.initials: MA
authors.lastname: Cerqueira
authors.forename: Jose C
authors.initials: JC
authors.lastname: Almeida
authors.forename: Alexandre
authors.initials: A
authors.lastname: Pompeo
authors.forename: David
authors.initials: D
authors.lastname: Sehrt
authors.forename: Jose M
authors.initials: JM
authors.lastname: Calheiros
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Martins
authors.forename: Wilson R
authors.initials: WR
authors.lastname: Molina
mesh_terms: D000368:Aged; D001938:Brazil; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D015203:Reproducibility of Results; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen