Cryosurgery would be An Effective Option for Clinically Localized Prostate Cancer: A Meta-analysis and Systematic Review

Gao, Liang; Yang, Lu; Qian, Shengqiang; Tang, Zhuang; Qin, Feng; Wang, Qiang; Han, Ping; Yuan, Jiuhong

doi:10.1038/srep27490

Cited by 23 publications

(10 citation statements)

References 58 publications

(185 reference statements)

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“…However, this study lacked a comparison group. A recent review conducted on cryotherapy concluded comparable survival benefits of cryotherapy over other treatments such as radiation therapy ( Gao et al, 2016 ). However, due to the limitations in available evidence in literature, assessment of comparative benefits and harm of these treatments has been difficult.…”

Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients

2018

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The high frequency of treatment-related side effects for men with localized prostate cancer creates uncertainty for treatment outcomes. This study assessed the comparative effectiveness of treatment-related side effects associated with conservative management and cryotherapy in patients with localized prostate cancer. A retrospective longitudinal cohort study was conducted, using the linked data of the Surveillance, Epidemiology, and End Results and Medicare, which included patients diagnosed from 2000 through year 2013, and their Medicare claims information from 2000 through 2014. To compare the differences in baseline characteristics and treatment-related side effects between the study cohorts, χ2 tests were conducted. Multivariate logistic regression was used to assess the association between treatment selection and side effects. There were 7,998 and 3,051 patients in the conservative management and cryotherapy cohort, respectively. The likelihood of erectile dysfunction, lower urinary tract obstruction, urinary fistula, urinary incontinence, and hydronephrosis was reported to be significantly lower (53%, 35%, 69%, 65%, and 36%, respectively) in the conservative management cohort. Conservative management had a lower likelihood of treatment-related side effects compared to cryotherapy. However, further research is needed to compare other significant long-term outcomes such as costs associated with these treatment choices and quality of life.

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Section: Discussionmentioning

confidence: 99%

Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients

2018

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“…Less commonly, low-dose (permanent implantation) and high-dose (temporary implantation) brachytherapy may be used in conjunction with IMRT/IGRT on patients with intermediate- and high-risk localized PCa who satisfy certain conditions [ 27 ]. Other still-experimental treatment modalities include cryosurgery [ 40 ], high-intensity focal ultrasound [ 41 ], irreversible electroporation [ 42 ] and photodynamic therapy [ 43 ]. However, these are not recommended unless part of a clinical trial.…”

Section: Prostate Cancer Backgroundmentioning

confidence: 99%

Novel Combinatorial Approaches to Tackle the Immunosuppressive Microenvironment of Prostate Cancer

Shackleton

Ali

Khan

et al. 2021

Cancers

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Prostate cancer (PCa) is the second-most common cancer in men worldwide and treatment options for patients with advanced or aggressive prostate cancer or recurrent disease continue to be of limited success and are rarely curative. Despite immune checkpoint blockade (ICB) efficacy in some melanoma, lung, kidney and breast cancers, immunotherapy efforts have been remarkably unsuccessful in PCa. One hypothesis behind this lack of efficacy is the generation of a distinctly immunosuppressive prostate tumor microenvironment (TME) by regulatory T cells, MDSCs, and type 2 macrophages which have been implicated in a variety of pathological conditions including solid cancers. In PCa, Tregs and MDSCs are attracted to TME by low-grade chronic inflammatory signals, while tissue-resident type 2 macrophages are induced by cytokines such as IL4, IL10, IL13, transforming growth factor beta (TGFβ) or prostaglandin E2 (PGE2) produced by Th2 cells. These then drive tumor progression, therapy resistance and the generation of castration resistance, ultimately conferring a poor prognosis. The biology of MDSC and Treg is highly complex and the development, proliferation, maturation or function can each be pharmacologically mediated to counteract the immunosuppressive effects of these cells. Herein, we present a critical review of Treg, MDSC and M2 involvement in PCa progression but also investigate a newly recognized type of immune suppression induced by the chronic stimulation of the sympathetic adrenergic signaling pathway and propose targeted strategies to be used in a combinatorial modality with immunotherapy interventions such as ICB, Sipuleucel-T or antitumor vaccines for an enhanced anti-PCa tumor immune response. We conclude that a strategic sequence of therapeutic interventions in combination with additional holistic measures will be necessary to achieve maximum benefit for PCa patients.

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“…Needles placement and cryotherapy procedure monitoring are performed under transrectal-US (TRUS) or MRI-real time monitoring (96). Cryotherapy has been extensively used both for whole and partial gland ablation (97), preserving genito-urinary structures and function from injury and suggesting acceptable disease control for both procedures (98).…”

Section: Cryotherapymentioning

confidence: 99%

The prostate cancer focal therapy

et al. 2018

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Despite prostate cancer (PCa) is the leading form of non-cutaneous cancer in men, most patients with PCa die with disease rather than of the disease. Therefore, the risk of overtreatment should be considered by clinicians who have to distinguish between patients with high risk PCa (who would benefit from radical treatment) and patients who may be managed more conservatively, such as through active surveillance or emerging focal therapy (FT). The aim of FT is to eradicate clinically significant disease while protecting key genito-urinary structures and function from injury. While effectiveness studies comparing FT with conventional care options are still lacking, the rationale supporting FT relies on evidence-based advances such as the understanding of the index lesion's central role in the natural history of the PCa and the improvement of multiparametric magnetic resonance imaging (mpMRI) in the detection and risk stratification of PCa. In this literature review, we want to highlight the rationale for FT in PCa management and the current evidence on patient eligibility. Furthermore, we summarize the best imaging modalities to localize the target lesion, describe the current FT techniques in PCa, provide an update on their oncological outcomes and highlight trends for future research.

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Cryosurgery would be An Effective Option for Clinically Localized Prostate Cancer: A Meta-analysis and Systematic Review

Cited by 23 publications

References 58 publications

Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients

Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients

Novel Combinatorial Approaches to Tackle the Immunosuppressive Microenvironment of Prostate Cancer

The prostate cancer focal therapy

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