Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging.

Autor: Sze C; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA. christina.sze89@gmail.com.; Division of Urology, Department of Surgery, Duke University Medical Center, Box 2804, Yellow Zone, Durham, NC, 27710, USA. christina.sze89@gmail.com., Tsivian E; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA., Tay KJ; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA.; Singapore General Hospital, Singapore, Singapore., Schulman AA; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA., Davis LG; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA., Gupta RT; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA.; Department of Radiology, Duke University Medical Center, Durham, NC, USA., Polascik TJ; Urologic Surgery, Duke University Medical Center and the Duke Cancer Institute, Durham, NC, USA.
Jazyk: angličtina
Zdroj: BMC urology [BMC Urol] 2019 Dec 05; Vol. 19 (1), pp. 127. Date of Electronic Publication: 2019 Dec 05.
DOI: 10.1186/s12894-019-0562-5
Abstrakt: Background: Due to their location away from the nerve bundles, anterior prostate cancers (APC) represent a rational target for image-guided cryoablation. This report describes the feasibility and short-term outcomes of anterior focal cryosurgery.
Methods: A retrospective review between 2012 and 2016 of patients with clinically localized APC treated with anterior gland cryoablation was performed. Descriptive statistics were used to report: age, PSA, prostate volume, prostate cancer grade group (PGG), median time to follow-up, and changes in functional status measured with the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF-5) score.
Results: A total of 17 patients underwent anterior focal cryoablation with a median follow-up of 15 months. Median age and PSA at diagnosis were 67 years and 8.7 ng/mL. Pre-operative PGG1 was identified in 12 (71%) men and PGG2 in 5 (29%) men. Median (IQR) lesion volume was 2 mL(0.86, 3.1). Preoperative median IIEF-5 and IPSS scores were 19.5 and 5, and decreased to 19 and 4, post-operatively. All patients remained continent with no change in sexual function. All post-procedure targeted biopsies of the treated cancers were negative.
Conclusion: Our pilot study demonstrates the feasibility of treating APCs with image-guided targeted focal cryoablation as a good balance between short-term oncologic control and near complete preservation of genitourinary function. Further follow-up is necessary to examine the potential benefits long-term.
Databáze: MEDLINE
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