Cryosurgery for prostate cancer: New technology and indications

Benoit, Ronald M.; Cohen, Jeffrey K.; Miller, Rodney A.

doi:10.1007/s11934-000-0034-0

Cited by 34 publications

(13 citation statements)

References 33 publications

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“…4 patients (4.0%) reported mild incontinence requiring 1-2 pads per day after therapy, compared to the published rate of 4.4% [3]. The currently reported incidence of urethral sloughing in patients undergoing cryosurgery with the use of a urethralwarming catheter ranges from 0 to 15% [18][19][20], and urethral sloughing occurred in 5 of the 102 patients (4.9%) in the present series. No patients developed fistulae in the present series, consistent with the risk of \1% reported in a recent study [10].…”

Section: Discussioncontrasting

confidence: 50%

Cryosurgery as primary treatment for localized prostate cancer

et al. 2011

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Section: Discussioncontrasting

confidence: 50%

Cryosurgery as primary treatment for localized prostate cancer

et al. 2011

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“…Its use is mostly confined to lower-risk patients with a PSA G10 ng/ml [27,28]. The 5-year DFS range is from 23 to 74% [26,[29][30][31][32][33] with side effects including incontinence and erectile dysfunction in 960% of men [27]. A report from the Cryo On-Line Data (COLD) registry reported data for 279 patients who underwent salvage cryoablation.…”

Section: Role Of Cryotherapy and High-intensity Focused Ultrasoundmentioning

confidence: 99%

Management Options for Biochemically Recurrent Prostate Cancer

Fakhrejahani

Madan

Dahut

2017

Curr. Treat. Options in Oncol.

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Prostate cancer is the most common solid tumor malignancy in men worldwide. Treatment with surgery and radiation can be curative in organ-confined disease. Unfortunately, about one third of men develop biochemically recurrent disease based only on rising prostate-specific antigen (PSA) in the absence of visible disease on conventional imaging. For these patients with biochemical recurrent prostate cancer, there is no uniform guideline for subsequent management. Based on available data, it seems prudent that biochemical recurrent prostate cancer should initially be evaluated for salvage radiation or prostatectomy, with curative intent. In selected cases, high-intensity focused ultrasound and cryotherapy may be considered in patients that meet very narrow criteria as defined by non-randomized trials. If salvage options are not practical or unsuccessful, androgen deprivation therapy (ADT) is a standard option for disease control. While some patients prefer ADT to manage the disease immediately, others defer treatment because of the associated toxicity. In the absence of definitive randomized data, patients may be followed using PSA doubling time as a trigger to initiate ADT. Based on retrospective data, a PSA doubling time of less than 3-6 months has been associated with near-term development of metastasis and thus could be used signal to initiate ADT. Once treatment is begun, patients and their providers can choose between an intermittent and continuous ADT strategy. The intermittent approach may limit side effects but in patients with metastatic disease studies could not exclude a 20% greater risk of death. In men with biochemical recurrence, large studies have shown that intermittent therapy is non-inferior to continuous therapy, thus making this a reasonable option. Since biochemically recurrent prostate cancer is defined by technological limitations of radiographic detection, as new imaging (i.e., PSMA) strategies are developed, it may alter how the disease is monitored and perhaps managed. Furthermore, patients have no symptoms related to their disease and thus many prefer options that minimize toxicity. For this reason, herbal agents and immunotherapy are under investigation as potential alternatives to ADT and its accompanying side effects. New therapeutic options combined with improved imaging to evaluate the disease may markedly change how biochemically recurrent prostate cancer is managed in the future.

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“…113 In addition, recent advances in cryotherapy, such as the use of smaller-gauge probes, argon-based probes (as opposed to traditional nitrogen-based probes), and improved imaging techniques have all lead to increased efficacy with a reduction in severe side effects. 114 This approach to the treatment of prostate cancer is also seen as a safe alternative for patients who are not good surgical candidates for radical prostatectomy. Several studies have demonstrated the advantages and disadvantages of focal therapy.…”

Section: Cryotherapy For Prostate Cancermentioning

confidence: 99%

Biomarker, Molecular, and Technologic Advances in Urologic Pathology, Oncology, and Imaging

Ellis

Harik

Cohen

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Urologic pathology is evolving rapidly. Emerging trends include the expanded diagnostic utility of biomarkers and molecular testing, as well as adapting to the plethora of technical advances occurring in genitourinary oncology, surgical practice, and imaging. We illustrate those trends by highlighting our approach to the diagnostic workup of a few selected disease entities that pathologists may encounter, including newly recognized subtypes of renal cell carcinoma, pheochromocytoma, and prostate cancer, some of which harbor a distinctive chromosomal translocation, gene loss, or mutation. We illustrate applications of immunohistochemistry for differential diagnosis of needle core renal biopsies, intraductal carcinoma of the prostate, and amyloidosis and cite encouraging results from early studies using targeted gene expression panels to predict recurrence after prostate cancer surgery. At our institution, pathologists are working closely with urologic surgeons and interventional radiologists to explore the use of intraoperative frozen sections for margins and nerve sparing during robotic prostatectomy, to pioneer minimally invasive videoscopic inguinal lymphadenectomy, and to refine image-guided needle core biopsies and cryotherapy of prostate cancer as well as blue-light/fluorescence cystoscopy. This collaborative, multidisciplinary approach enhances clinical management and research, and optimizes the care of patients with urologic disorders. (Arch Pathol Lab Med. 2017;141:499-516; doi: 10.5858.arpa.2016-0263-SA) I n this review, we summarize the effect of a number of biomarker, molecular, and technologic advances in urologic pathology, oncology, and imaging on routine, day-to-day practice and research at our institution. The objective of this review is not to cover the entire gamut of all advances that we have and use at our institution but, rather, to highlight a few pertinent concepts in our field. Topics that will be covered include biomarkers, molecular testing of selected malignancies (eg, transcription factor E3 [TFE3]/ Xp11.2 translocation-associated renal cell carcinoma; p63, high-molecular-weight cytokeratin and racemase cocktail [PIN4]/phosphatase and tensin homolog [PTEN] for some cases of intraductal carcinoma of the prostate; and succinate dehydrogenase subunit B in renal cell carcinoma and pheochromocytoma), amyloidosis of the genitourinary tract, and workup of neoplastic needle core kidney biopsies. In addition, we will report the effect of pathologic, oncologic, and radiologic technologic advances (ie, global transcriptome analysis and RNA biomarkers of prostate cancer; robotic-assisted radical prostatectomy; minimally invasive videoscopic inguinal lymphadenectomy; targeted magnetic resonance imaging [MRI]-guided prostate needle core biopsies; anti-1-amino-3-fluorine 18-fluorocyclobutane-1-carboxylic acid in prostate cancer; cryotherapy for prostate cancer; and blue-light/white-light cystoscopy for bladder lesions) performed at our institution.

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Cryosurgery for prostate cancer: New technology and indications

Cited by 34 publications

References 33 publications

Cryosurgery as primary treatment for localized prostate cancer

Cryosurgery as primary treatment for localized prostate cancer

Management Options for Biochemically Recurrent Prostate Cancer

Biomarker, Molecular, and Technologic Advances in Urologic Pathology, Oncology, and Imaging

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