Is whole gland salvage cryotherapy effective as palliative treatment of haematuria in patients with locally advanced prostate cancer? Results of a preliminary case series
| Autor: | Francesco Lembo, Carlo Magno, Salvatore Butticè, Giuseppe Mucciardi, Alessandro Galì, G. Anastasi, Rosa Pappalardo, Giorgio Ascenti, Franco Lugnani |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
haemostatic treatments Palliative treatment business.industry Urology medicine.medical_treatment Locally advanced Cryotherapy Cryoablation urologic and male genital diseases lcsh:Diseases of the genitourinary system. Urology lcsh:RC870-923 medicine.disease Bladder Irrigation haematuria Surgery Radiation therapy Bladder outlet obstruction Prostate cancer locally advanced prostate cancer (LAPC) Medicine business cryotherapy Original Research |
| Zdroj: | Therapeutic Advances in Urology, Vol 7 (2015) |
| ISSN: | 1756-2880 1756-2872 |
| DOI: | 10.1177/1756287215585451 |
| Popis: | Objectives: Locally advanced prostate cancer may cause several complications such as haematuria, bladder outlet obstruction, and renal failure due to the ureteral obstruction. Various treatments have been suggested, including radiotherapy, antifibrinolytics, bladder irrigation with alum solution, transurethral surgery and angioembolization, none of which have proven effectiveness. In the last years cryoablation has become a valid therapeutic option for prostate cancer. In our experience we used this ‘new’ technique as haemostatic therapy. Methods: We selected four patients with gross haematuria affected by locally advanced hormone refractory prostate cancer, who had already been treated with primary radiotherapy. We used third-generation cryotherapy: under ultrasonographic guidance, we inserted six cryoprobes, two in each of the vascular pedicles reaching at least −60°C, and three thermometers. We then induced two freeze–thaw cycles. Results: After the operation the haematuria stopped in all patients and at 9-month follow up we observed a mean of four red cells (range three to five) in the urinary sediment with no evidence of bacteriuria. Prostate volume, prostate-specific antigen and postmicturition residue were significantly reduced. Qmax improved significantly too. Conclusion: Our experience has given us good results with minimal intra- and postoperative complications. We think that haemostatic cryotherapy as a palliative approach for locally advanced prostate cancer could represent a valid treatment option and more consideration could be given to its use. |
| Databáze: | OpenAIRE |
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