Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer
Section snippets
Patient selection
Between March 1993 and September 2001, 590 consecutive patients were treated at Crittenton Hospital in Rochester, Michigan. Patients were eligible for inclusion if they exhibited localized or locally advanced disease (TNM stage T1 to T3).
Procedure
The methodology used in cryosurgical ablation of the prostate has evolved significantly since its reintroduction by Onik et al.23 in 1993. The modern procedure has used the following advances: 2 freeze cycles, use of US Food and Drug Administration
Results
Retrospective analysis of 590 consecutive patients who underwent TCAP procedures with curative intent between March 1994 and September 2001 was performed. The mean age of the sample was 70.76 years, with the median age being 71.13 years. Mean follow-up time was 5.43 years, and the median follow-up time was 5.72 years.
In all, 16.4% of the sample had a presurgery PSA level <4 ng/mL, 58.9% had a PSA level of 4 to 10 ng/mL, and 24.5% had a PSA level >10 ng/mL; 41.5% of the sample had a Gleason
Discussion
Cryoablation treatment of prostate cancer is a technique that was originally introduced in the 1960s, but was abandoned because of excessive morbidity. Use of this approach was resurrected with the introduction by Onik et al.23 in 1993 of a modern transrectal ultrasound-guided percutaneous method. The treatment itself has undergone an evolution, which has stemmed from recent developments in interventional radiology, has improved cryogenic technology, and has provided a better knowledge of
Conclusion
We have shown that the 7-year efficacy rates of TCAP are comparable or superior to the rates of efficacy of all conventional radiation therapy modalities for prostate cancer. There are several other advantages to cryoablation treatment over conventional prostate cancer therapy. Cryoablation requires only a short hospital stay, with most patients being able to be discharged within 24 hours. The procedure can be applied in cases of locally advanced cancer because of the ability to extend the
Acknowledgements
We gratefully acknowledge the assistance of Mark Rose, MA, for valuable help during the preparation of the primary transcript, and Eric Bahn for chart review and data entry.
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Michael Chernick is a biostatistics consultant to the sponsor of this supplement.