Three-Dimensional Transrectal Ultrasound Guided Cryoablation for Localized Prostate Cancer in Nonsurgical Candidates: A Feasibility Study and Report of Early Results

Chin, Joseph L.; Downey, Dónal B.; Mulligan, Michael J.; Fenster, Aaron

doi:10.1016/s0022-5347(01)63769-8

Cited by 83 publications

(46 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Proper probe placement was confirmed on 3-D ultrasound in terms of inter-probe distances, probe orientation and depth. 4,5 In most cases, 5 cryoprobes (range 2-8) were inserted with a transperineal approach using the Seldinger technique after initial prostatic access by needle puncture. All patients underwent 2 freeze-thaw cycles, with the urethra protected by a urethral warmer (Cook Medical, Inc., Bloomington, IN).…”

Section: Methodsmentioning

confidence: 99%

The pattern of prostate cancer local recurrence after radiation and salvage cryoablation

Touma

Chalasani

et al. 2013

CUAJ

Self Cite

View full text Add to dashboard Cite

Objective: We assessed the pattern of local recurrence after salvage cryoablation of the prostate, and the impact of local recurrence on intermediate-term outcome. Methods: One hundred twenty-two patients who underwent salvage cryoablation were studied after a mean follow-up of 56 months. Serial prostate biopsy was carried out after cryoablation. The histopathology of prostate biopsies before and after cryoablation were compared. The prognostic value of post-cryoablation biopsy was assessed with the Cox regression method. Results: 23.1% of patients had a positive biopsy for prostate cancer following salvage cryoablation. Most cancer recurrences occurred in the apex (51.5%), base (21.2%) and seminal vesicles (18.2%). The presence of cancer at the base of the prostate was found to be a prognostic factor for eventual biochemical failure. Overall 5-year biochemical disease-free survival (bDFS) was 28%, however patients with cancer at the base of the prostate had a 5-year bDFS of 0%. Conclusion: Cancer recurrences occurred in areas where aggressive freezing was avoided as it might result in serious problems (e.g., urethro-rectal fistula and incontinence). Post-cryoablation biopsies and the location of persistent disease are of prognostic value.

show abstract

Section: Methodsmentioning

confidence: 99%

The pattern of prostate cancer local recurrence after radiation and salvage cryoablation

Touma

Chalasani

et al. 2013

CUAJ

Self Cite

View full text Add to dashboard Cite

show abstract

“…Based on other recent studies, a PSA greater than 10 ng/ml, [40][41][42] a high Gleason score before or after radiotherapy, [41][42][43] stage T3/T4 disease, 41 and a higher grade of cancer 44 all predict unfavorable outcomes. In addition to evidence of metastatic disease, patients with a prior history of transurethral resection of the prostate (TURP) should be excluded from salvage cryoablation due to the heightened risk of sloughing and urinary retention.…”

Section: 3940mentioning

confidence: 96%

Role of transrectal ultrasound guided salvage cryosurgery for recurrent prostate carcinoma after radiotherapy

Donnelly

Saliken

Ernst

et al. 2005

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

Despite improvements in treatment of localized prostate cancer, local recurrence remains a significant problem. A total of 46 patients with proven local cancer recurrence following external beam radiotherapy entered a prospective clinical trial using ultrasound-guided cryosurgery to ablate the residual prostate gland. Persistent complications included one urethra-rectal fistula, incontinence (2), retention (3), and treatment induced erectile dysfunction (7). Using the PSA definitions for biochemical failure as PSA X0.3 ng/ml, the Kaplan-Meier plots showed the incidence of patients to be free of biochemical recurrence at 51 and 44% at 1 and 2 y, respectively. For a PSA X1.0, the values at 1 and 2 y were 72 and 58%.

show abstract

“…Details of the cryosurgery methodology have been reported previously. [11][12][13] Briefly, proper probe placement was confirmed on three-dimensional ultrasound in terms of inter-probe distances, probe orientation and depth of insertion. In most cases, five cryoprobes (range 2-8) were used and two freezethaw cycles were administered with the urethra protected by a urethra-warming device (Cook Urologic Inc., Spencer, IN, USA).…”

Section: Cryo Proceduresmentioning

confidence: 99%

Randomized trial comparing cryoablation and external beam radiotherapy for T2C-T3B prostate cancer

Chin

Touma

et al. 2007

Prostate Cancer Prostatic Dis

View full text Add to dashboard Cite

The objective was to evaluate the relative efficacy of cryoablation (CRYO) versus external beam radiation (EBRT) for clinically locally advanced prostate cancer in a randomized clinical trial. Patients with histologically proven, clinically staged as T2C, T3A or T3B disease were randomized with 6 months of perioperative hormone therapy to one of the two procedures. Owing largely to a shift in practice to longer term adjuvant hormonal therapy and higher doses of radiation for T3 disease, only 64 out of the planned 150 patients were accrued. Twenty-one of 33 (64%) in the CRYO group and 14 of 31 (45%) in the EBRT-treated group who had met the ASTRO definition of failure were also classified as treatment failure. The mean biochemical disease-free survival (bDFS) was 41 months for the EBRT group compared to 28 months for the CRYO group. The 4-year bDFS for EBRT and CRYO groups were 47 and 13%, respectively. Disease-specific survival (DSS) and overall survival (OS) for both groups were very similar. Serious complications were uncommon in either group. EBRT patients exhibited gastrointestinal (GI) adverse effects more frequently. Taking into account the relative deficiency in numbers and the original trial design, this prospective randomized trial indicated that the results of CRYO were less favorable compared to those of EBRT, and was suboptimal primary therapy in locally advanced prostate cancer.

show abstract

Three-Dimensional Transrectal Ultrasound Guided Cryoablation for Localized Prostate Cancer in Nonsurgical Candidates: A Feasibility Study and Report of Early Results

Cited by 83 publications

References 18 publications

The pattern of prostate cancer local recurrence after radiation and salvage cryoablation

The pattern of prostate cancer local recurrence after radiation and salvage cryoablation

Role of transrectal ultrasound guided salvage cryosurgery for recurrent prostate carcinoma after radiotherapy

Randomized trial comparing cryoablation and external beam radiotherapy for T2C-T3B prostate cancer

Contact Info

Product

Resources

About