“Results of Salvage Cryoablation of the Prostate After Radiation: Identifying Predictors of Treatment Failures and Complications”
Joseph L. Chin,* Stephen E. Pautler, Vladamir Mouraviev,† Naju Touma, Kimberly Moore and Donal B. Downey. The Journal Of Urology® Vol. 165, 1937–1942, June 2001 Copyright © 2001 by American Urological Association, Inc.
Physicians in this study tracked
118 patients with proven local recurrence for 6, 12,
and 24 months that had received cryotherapy
after full dose radiotherapy. Patients were placed into
one of three risk groups based on clinical characteristics.
The results revealed that 114 had a PSA
less than .5 after 18.6 months. Only 7 patients or 3.1%
(23 of 745) showed a biopsy core containing persistent
cancer. Approximately 87% remained free of histologic
failure. Those with a PSA level greater than 4 exhibited
68% biochemical failure, at 2 it reached 55%, and at
.5 it reached 34%. Prior to cryotherapy patient who
had a PSA greater than 10, a Gleason
score of 8 or greater before radiation, and a stage
T3/T4 did not respond as well.
“Results of Salvage Cryoablation of the Prostate After Radiation:: Identifying Predictors of Treatment Failures and Complications”
CHIN, JOSEPH L.; PAUTLER, STEPHEN E.; MOURAVIEV, VLADAMIR; TOUMA, NAJU; MOORE, KIMBERLY; DOWNEY, DONAL B. Journal of Urology. 165(6, Part 1 of 2):1937-1942, June 2001.
In this study 125 cryoablation
procedures were performed in 118 patients with proven
local recurrence after full dose radiotherapy. At 6,
12, and 24 months doctors tracked patients PSA levels
and biopsy results. Based on T stage, Gleason score,
prior PSA, and endocrine therapy status patients were
placed into different cohorts and analyzed accordingly.
Out of 118, 114 patients had a PSA nadir less than 0.5ng/mL.
From the biopsy results, 7 patients (3.1%) were found
to have contained persistent viable cancer. Eighty seven
percent of patients were free of histological failure.
There were 68% with a PSA greater than 4 that were free
from biochemical failure, 55% with a PSA of 2, and 34%
with a PSA of 0.5. Complications consisted of 4 rectourethral
fistulas (3.3%) and 6.7% had severe incontinence.