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

Li, Roger; Ruckle, Herbert C.; Schlaifer, Amy; Elshafei, Ahmed; Yu, Changhong; Jones, J. Stephen

doi:10.1016/j.urology.2014.12.025

Cited by 12 publications

(14 citation statements)

References 29 publications

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“…An early study has investigated the effect of the combination of androgen deprivation with salvage surgery in patients with radiorecurrent prostate cancer and suggested that patients in whom an initial trial of ADT failed were poor candidates for salvage prostatectomy [ 36 ]. Similarly, for whole-gland salvage prostate cryoablation one study has recently shown that patients receiving ADT before salvage cryoablation had worse 5-year biochemical progression-free survival [ 37 ]. One explanation is that the initiation of ADT before salvage cryoablation may have concealed rising PSA levels, masking micrometastatic disease progression.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous MR-guided focal cryoablation for recurrent prostate cancer following radiation therapy: retrospective analysis of iceball margins and outcomes

et al. 2017

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ObjectivesTo evaluate iceball margins after magnetic resonance (MR)-guided focal salvage prostate cryoablation and determine the correlation with local outcome.MethodsA retrospective review was performed on 47 patients that underwent percutaneous MR-guided focal cryoablation for biopsy-proven locally recurrent prostate cancer after primary radiotherapy. Preprocedural diagnostic and intraprocedural MR images were analysed to derive three-directional iceball margins. Local tumour progression after cryoablation was defined as evident tumour recurrence on follow-up MRI, positive MR-guided biopsy or biochemical failure without radiological evidence of metastatic disease.ResultsMean iceball margins were 8.9 mm (range −7.1 to 16.2), 10.1 mm (range 1.1–20.3) and 12.5 mm (range −1.5 to 22.2) in anteroposterior, left–right and craniocaudal direction respectively. Iceball margins were significantly smaller for tumours that were larger (P = .008) or located in the posterior gland (P = .047). Significantly improved local progression-free survival at 1 year post focal cryoablation was seen between patients with iceball margin >10 mm (100%), 5–10 mm (84%) and <5 mm (15%) (P < .001).ConclusionsIceball margins appear to correlate with local outcome following MR-guided focal salvage prostate cryoablation. Our initial data suggest that freezing should be applied at minimum 5 mm beyond the border of an MR-visible recurrent prostate tumour for successful ablation, with a wider margin appearing desirable.Key points• Shortest iceball margin most often occurred in anteroposterior direction • Margins were smaller in tumours that were larger or posteriorly located • Minimum iceball margin was a predictor of early local tumour progression • A minimum 5-mm margin seems required for effective cryoablation of recurrent PCa

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Section: Discussionmentioning

confidence: 99%

Percutaneous MR-guided focal cryoablation for recurrent prostate cancer following radiation therapy: retrospective analysis of iceball margins and outcomes

et al. 2017

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“…However, recovery may be delayed or incomplete. 5,6 Chemotherapy agents such as cisplatin or vincristine may interfere with the nerves and vasculature that control erection. Adverse effects of cisplatin in combination with vinblastine and bleomycin treatment include nephrotoxicity, myelosuppression, pulmonary toxicity, therapy-related secondary malignancies, vascular toxicity, neurotoxicity, and infertility.…”

Section: Chemotherapy Hormone Therapymentioning

confidence: 99%

Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer

Voznesensky

Annam

Kreder

2016

JOP

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Cancer can cause sexual adverse effects by direct and indirect pathways. It can involve sexual organs, indirectly affect body image, or cause fatigue or depression with subsequent effects on libido. Erectile dysfunction (ED), the inability to obtain or maintain an erection firm enough for sexual intercourse, can also result from adverse effects of cancer treatment, such as fatigue, pain, or anxiety about therapy. In addition, depressed feelings about having cancer can affect sexuality, causing a range of signs and symptoms that can lead to ED. Chemotherapy, hormone therapy, surgery, and radiation can all cause sexual adverse effects. Additional factors that play a role include patient age and degree of ED before starting cancer treatment. In this article, we discuss how chemotherapy, hormone therapy, surgery, and radiation affect erectile function as well as possible treatment options for ED.

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“…Li et al [19] in a study of 740 patients who underwent STC showed a 5-year BCRFS of 39.3% and 63.3% for the pre-STC ADT and no ADT groups, respectively. The literature postulates that ADT may be delaying and masking the window of opportunity for definitive therapy of hormone independent clonal population of PCa cells [18,19]. To date, none of the three SFC studies have addressed the effect of ADT on BCRFS [21].…”

Section: Discussionmentioning

confidence: 98%

“…This finding is vastly different from what has been reported in the literature. The use of ADT, particularly before salvage total cryotherapy (STC), leads to lower BCRFS [18][19][20]. Li et al [19] in a study of 740 patients who underwent STC showed a 5-year BCRFS of 39.3% and 63.3% for the pre-STC ADT and no ADT groups, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…The use of ADT, particularly before salvage total cryotherapy (STC), leads to lower BCRFS [18][19][20]. Li et al [19] in a study of 740 patients who underwent STC showed a 5-year BCRFS of 39.3% and 63.3% for the pre-STC ADT and no ADT groups, respectively. The literature postulates that ADT may be delaying and masking the window of opportunity for definitive therapy of hormone independent clonal population of PCa cells [18,19].…”

Section: Discussionmentioning

confidence: 99%

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Salvage focal cryosurgery may delay use of androgen deprivation therapy in cryotherapy and radiation recurrent prostate cancer patients

Kongnyuy

Berg

Kosinski

et al. 2017

International Journal of Hyperthermia

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

Cited by 12 publications

References 29 publications

Percutaneous MR-guided focal cryoablation for recurrent prostate cancer following radiation therapy: retrospective analysis of iceball margins and outcomes

Percutaneous MR-guided focal cryoablation for recurrent prostate cancer following radiation therapy: retrospective analysis of iceball margins and outcomes

Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer

Salvage focal cryosurgery may delay use of androgen deprivation therapy in cryotherapy and radiation recurrent prostate cancer patients

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