mpMRI-US Fusion-Guided Targeted Cryotherapy in Patients with Primary Localized Prostate Cancer: A Prospective Analysis of Oncological and Functional Outcomes.

Autor: Fernández-Pascual E; LYX Institute of Urology, Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain.; Department of Urology, Hospital Universitario La Paz, 28046 Madrid, Spain., Manfredi C; Urology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania 'Luigi Vanvitelli', 80131 Naples, Italy., Martín C; LYX Institute of Urology, Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain., Martínez-Ballesteros C; LYX Institute of Urology, Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain.; Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, 28222 Madrid, Spain., Balmori C; LYX Institute of Urology, Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain., Lledó-García E; Department of Urology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain., Quintana LM; Department of Urology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain., Curvo R; Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, 28222 Madrid, Spain., Carballido-Rodríguez J; Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, 28222 Madrid, Spain., Bianco FJ Jr; Urological Research Network, Miami, FL 33016, USA., Martínez-Salamanca JI; LYX Institute of Urology, Faculty of Medicine, Universidad Francisco de Vitoria, 28223 Madrid, Spain.; Department of Urology, Hospital Universitario Puerta De Hierro-Majadahonda, 28222 Madrid, Spain.
Jazyk: angličtina
Zdroj: Cancers [Cancers (Basel)] 2022 Jun 17; Vol. 14 (12). Date of Electronic Publication: 2022 Jun 17.
DOI: 10.3390/cancers14122988
Abstrakt: Targeted therapy (TT) for prostate cancer (PCa) aims to ablate the malignant lesion with an adequate margin of safety in order to obtain similar oncological outcomes, but with less toxicity than radical treatments. The main aim of this study was to evaluate the recurrence rate (RR) in patients with primary localized PCa undergoing mpMRI/US fusion targeted cryotherapy (FTC). A secondary objective was to evaluate prostate-specific antigen (PSA) as a predictor of recurrences. We designed a prospective single-center single-cohort study. Patients with primary localized PCa, mono or multifocal lesions, PSA ≤ 15 ng/mL, and a Gleason score (GS) ≤ 4 + 3 undergoing FTC were enrolled. RR was chosen as the primary outcome. Recurrence was defined as the presence of clinically significant prostate cancer in the treated areas. PSA values measured at different times were tested as predictors of recurrence. Continuous variables were assessed with the Bayesian t -test and categorical assessments with the chix-squared test. Univariate and logistic regression assessment were used for predictions. A total of 75 cases were included in the study. Ten subjects developed a recurrence (RR: 15.2%), while fifty-six (84.8%) patients showed a recurrence-free status. A %PSA drop of 31.5% during the first 12 months after treatment predicted a recurrence with a sensitivity of 53.8% and a specificity of 79.2%. A PSA drop of 55.3% 12 months after treatment predicted a recurrence with a sensitivity of 91.7% and a specificity of 51.9%. FTC for primary localized PCa seems to be associated with a low but not negligible percentage of recurrences. Serum PSA levels may have a role indicating RR.
Databáze: MEDLINE
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