Salvage Cryosurgery of the Prostate for Failure After Primary Radiotherapy or Cryosurgery: Long-term Clinical, Functional, and Oncologic Outcomes in a Large Cohort at a Tertiary Referral Centre

The Effect of Androgen Deprivation Therapy Before Salvage Whole-gland Cryoablation After Primary Radiation Failure in Prostate Cancer Treatment

“…4 Recently, salvage cryoablation (SC) has emerged as a less-invasive alternative with lower perioperative morbidity profile. [5][6][7] However, with cancer recurrence after SC ranging from 37%-49%, [5][6][7] several investigators have attempted to identify predictors of SC failure to improve patient selection. Preradiation oncologic parameters including Gleason score, prostate-specific antigen (PSA), and clinical stage, 8,9 as well as presalvage parameters such as Gleason score, PSA, 10 and PSA doubling time, 11 were some factors found to correlate with cancer recurrence after SC.…”

“…In addition, after SC, PSA nadir was also predictive of treatment failure. 7,10 In large, randomized, phase III studies, androgen deprivation therapy (ADT) given neoadjuvantly and/or continued through and after primary radiation treatment has been shown to improve cancer-specific and overall survival for intermediate-and high-risk prostate cancer patients. [12][13][14][15] In contrast, a recent study demonstrated that neoadjuvant ADT did not affect biochemical recurrence after primary cryoablation of the prostate.…”

Multivariable model development and internal validation for prostate cancer specific survival and overall survival after whole-gland salvage Iodine-125 prostate brachytherapy

“…However, there is no data on predictive factors for survival (PCaSS and OS). Predictive factors for survival in other salvage modalities (such as radical prostatectomy and cryosurgery) are more comprehensively defined, because of larger patient numbers and longer follow-up 7,8 . These factors (PSA pre-salvage, primary Gleason score, T-stage [both only univariable] and nadir after salvage, among other) are possibly important for salvage brachytherapy as well, but are not quantified in this setting with multivariable models.…”

“…Local salvage therapy is a potentially curative treatment for these prostate-confined recurrences. Whole-gland salvage can be performed using different techniques and is able to achieve long term biochemical control and survival and thereby postpone the use of androgen deprivation therapy (ADT) in carefully selected patient groups [5][6][7][8][9] . Risk factors for failure and mortality for salvage brachytherapy have not been comprehensively defined, because of small series with often limited events 5,9,10 .…”

Imaging technique for real-time temperature monitoring during cryotherapy of lesions

“…[1][2][3][4] Cryotherapy has gained acceptance as a clinical tool for the treatment of internal malignancies, including carcinomas of the prostate. [5][6][7][8][9] This method of tissue ablation belongs to a larger category of thermal therapies and causes cancer cells to undergo coagulative necrosis as a result of deep freezing. A modern cryosurgical procedure employs thin cryoprobes (needles) of about 1.5 to 3 mm in diameter, which are precisely positioned near the cancerous tissue guided by ultrasound (US) imaging.…”