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Single Center Experience With Third Generation Cryosurgery For Treatment Of Organ Confined Prostate Cancer: A Critical Evaluation Of Short Term Outcomes and Complications
Christopher M Tepera*1, Scott G Hubosky1, Michael D Fabrizio1, Paul F Schellhammer1, Bethany B Gambill*2, Robert W Given1
1Eastern Virginia Medical School, Norfolk, VA;2Urology of Virginia, Norfolk, VA
Introduction: With numerous modalities available for the treatment of clinically localized prostate cancer oncologic outcomes and complications are important for modality selection and patient counseling. The purpose of this study is to evaluate PSA outcomes and complications in patients after cryoablation of the prostate with third generation technology.
Methods: A chart review of all patients who underwent primary cryoablation of the prostate at our institution was performed. PSA levels were measured at baseline, 1, 3, 6, 12, and 18 months. Patients were stratified into low, intermediate and high-risk categories using a well-known classification scheme using pre-procedure PSA, Gleason score and clinical stage. PSA outcome data was analyzed using two definitions of failure: PSA>0.4 and the ASTRO definition of three consecutive rises in post treatment PSA. Complications were recorded as documented in the patient’s chart.
Results: Since March 2003, 89 patients who underwent cryoablation of the prostate were included in this review. Overall 82% of patients reached a PSA nadir of <0.1. At 12 months, 70% and 94% of patients achieved biochemical disease-free survival using PSA<=0.4 and ASTRO criteria, respectively. Sixteen percent of patients had a complication including fistula (1), urethral sloughing (2), prostatic cavitation (1), transient pain (5), retention (4) or incontinence (2). Only 2 required further intervention.
Conclusions: This study demonstrates that patients undergoing cryoablation of the prostate can expect a reasonable oncologic outcome when compared to other minimally invasive treatments, with low morbidity.
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