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Percutaneous prostate cryoablation as treatment for high-risk prostate cancer
Omar Reda El Hayek1, Wladimir Alfer, Ernesto Reggio
1Hospital das Clínicas, Medical School, São Paulo University, São Paulo, SP, Brazil. hayek@uol.com.br
Purpose:
To evaluate percutaneous cryotherapy as a primary treatment option for high-risk prostate cancer patients.
Patients And Methods:
From October 2000 to February 2005, 21 high-risk (Gleason e.8 and/or PSA > 10 and/or stage > T2a) prostate cancer patients underwent 24 percutaneous prostate cryoablation procedures. Patients' median age was 70.9, and the average pretreatment PSA was 19.5 ng/dL. The follow-up period ranged from 6 to 60 months (median, 41 months).
Results:
The PSA failure rate was 39%, 52.9%, and 42.8% at 12, 24, and 60 months of follow-up, respectively. Overall complication rates were low, with 8% of urinary incontinence and no cases of rectal injury; however, 96% of erectile dysfunction occurred. The cryoablation procedure failed in 12 patients (57.2%); 7 (58.3%) of these were local failures (positive prostate biopsies).
Conclusion:
Percutaneous cryoablation of the prostate is a safe minimally invasive treatment, but it has poor PSA-free survival outcomes in high-risk prostate cancer patients.
