title: Focal cryoablation for unilateral low-intermediate-risk prostate cancer: 63-month mean follow-up results of 41 patients.
abstract: OBJECTIVE
  To report (1) intermediate-term oncologic and functional outcomes of primary focal cryoablation (FC) in selected patients with clinically unilateral, low-intermediate-risk prostate cancer, and investigate (2) the impact of patient selection criteria at predicting outcomes after FC.
  
  
  METHODS
  Forty-one patients with unilateral prostate cancer were treated with FC. Patients were stratified using the 2007 Task Force Focal Prostate Cancer Patient selection criteria (Task Force criteria). Posttherapy follow-up included questionnaires, PSA measurement, and TRUS-guided biopsies.
  
  
  RESULTS
  Complete follow-up was available in 40 patients (median follow-up 63 months; range 12-92 months). Compared to precryotherapy PSA level (mean 7.1 ng/ml), postcryotherapy PSA level (mean 1.8 ng/ml) dropped by 75 % at 3 months (P < 0.0001) and this decline persisted throughout the follow-up period, with no significant difference seen across patient selection criteria (P = 0.859). The treatment failure rate was 10 % (4/40) with no significant difference seen across patient selection criteria (P = 0.832). Of 32 patients undergoing postcryotherapy biopsy, 7 (22 %) had positive biopsies (2 ipsilateral lobes, 5 contralateral lobes). Patients of Task Force criteria group were less likely to have positive biopsy in contralateral lobe than focal control group (P = 0.032). Complete continence (no pads) and potency sufficient for intercourse were documented in 97.6 and 76.9 % of patients, respectively.
  
  
  CONCLUSIONS
  The intermediate-term oncologic efficacy of primary FC in selected patients with clinically unilateral, low-intermediate-risk prostate cancer appears favorable, and the side-effect profile is low. The 2007 Task Force criteria appear to reduce the positive biopsy rate in contralateral lobe after FC.
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
authors.forename: Huibo
authors.initials: H
authors.lastname: Lian
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
authors.forename: Junlong
authors.initials: J
authors.lastname: Zhuang
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
authors.forename: Rong
authors.initials: R
authors.lastname: Yang
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
authors.forename: Feng
authors.initials: F
authors.lastname: Qu
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China.
authors.forename: Tingsheng
authors.initials: T
authors.lastname: Lin
authors.affiliation: Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. dr.guohongqian@gmail.com.
authors.forename: Hongqian
authors.initials: H
authors.lastname: Guo
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D003452:Cryosurgery / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: Carcinoma; Cryoablation; Focal; Prostatic neoplasms