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.
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.
Authors: J I Izawa; P Perrotte; G F Greene; S Scott; L Levy; E McGuire; L Madsen; A C von Eschenbach; L L Pisters Journal: J Urol Date: 2001-03 Impact factor: 7.450
Authors: Jonathan I Izawa; Nora Morganstern; Deva M Chan; Lawrence B Levy; Shellie M Scott; Louis L Pisters Journal: Int J Radiat Oncol Biol Phys Date: 2003-06-01 Impact factor: 7.038
Authors: Hakan Aydin; Toyonori Tsuzuki; David Hernandez; Patrick C Walsh; Alan W Partin; Jonathan I Epstein Journal: Urology Date: 2004-09 Impact factor: 2.649
Authors: Ken-Ryu Han; Jeff K Cohen; Ralph J Miller; Allan J Pantuck; Danielo G Freitas; Carlos A Cuevas; Hyung L Kim; James Lugg; Stacy J Childs; Barry Shuman; Maury A Jayson; Neal D Shore; Yan Moore; Amnon Zisman; Joe Y Lee; Roland Ugarte; Lance A Mynderse; Torrence M Wilson; Susan D Sweat; Horst Zincke; Arie S Belldegrun Journal: J Urol Date: 2003-10 Impact factor: 7.450
Authors: Joseph L Chin; Naji Touma; Stephen E Pautler; Karmdeep S Guram; Anthony J Bella; Donal B Downey; Madeleine Moussa Journal: J Urol Date: 2003-10 Impact factor: 7.450
Authors: Piyush K Agarwal; Natalia Sadetsky; Badrinath R Konety; Martin I Resnick; Peter R Carroll Journal: Cancer Date: 2008-01-15 Impact factor: 6.860
Authors: Wilfred Ngwa; Rajiv Kumar; Srinivas Sridhar; Houari Korideck; Piotr Zygmanski; Robert A Cormack; Ross Berbeco; G Mike Makrigiorgos Journal: Nanomedicine (Lond) Date: 2014-05 Impact factor: 5.307