Abstract:
OBJECTIVES:To present the oncological and functional outcomes of salvage focal (SFC) and salvage total (STC) cryoablation for recurrent prostate cancer (PCa) after failed primary radiotherapy. PATIENTS AND METHODS:From March 2003 to August 2010, 50 men with biopsy-proven unilateral (n = 25) or bilateral (n = 25) radio-recurrent PCa underwent SFC or STC, respectively. Patients were assessed after treatment by prostate-specific antigen (PSA) testing, transrectal ultrasonography, biopsy and questionnaires. Biochemical failure (BF) was defined using the Phoenix criteria (PSA nadir + 2 mg/mL). Data were prospectively collected and retrospectively analysed. RESULTS:The median pre-cryoablation PSA level and Gleason score were, respectively, 2.8 ng/mL and 7 for SFC, and 3.9 ng/mL and 7 for STC. The median follow-up was 31 and 53 months (P = 0.004) for SFC and STC, respectively. Oncological outcomes were as follows: no patient died; one patient who underwent STC developed bone metastases; eight patients who underwent SFC and three who underwent STC had BF and the 5-year BF-free survival rates were 54 and 86%, respectively. In those patients without BF, the mean PSA decreased by 86% for SFC and 90% for STC within the first year and remained stable. Functional outcomes were as follows: new onset urinary incontinence occurred in three (13%) patients in the STC group, whereas no patient in the SFC group developed incontinence (P = 0.10); Two of seven patients in the SFC group retained postoperative potency, but none of the four potent patients in the STC group recovered potency postoperatively (P = 0.48); one (4%) patient in the STC group developed a recto-urethral fistula, but none occurred in the SFC group (P = 0.48). CONCLUSIONS:SFC and STC are feasible and safe with acceptable mid-term oncological outcomes. For carefully selected patients, SFC is an option that could be associated with lower treatment-related morbidity compared with STC. Although longer follow-up and more patient numbers are needed, our initial oncological and functional outcomes of SFC and STC are encouraging.
journal_name
BJU Intjournal_title
BJU internationalauthors
de Castro Abreu AL,Bahn D,Leslie S,Shoji S,Silverman P,Desai MM,Gill IS,Ukimura Odoi
10.1111/bju.12151subject
Has Abstractpub_date
2013-08-01 00:00:00pages
298-307issue
3eissn
1464-4096issn
1464-410Xjournal_volume
112pub_type
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journal_title:BJU international
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pub_type: 杂志文章,多中心研究
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journal_title:BJU international
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2018-04-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2014-02-01 00:00:00
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journal_title:BJU international
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doi:10.1111/j.1464-410X.2005.05779.x
更新日期:2005-11-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:BJU international
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更新日期:2011-08-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章,随机对照试验
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更新日期:2012-12-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2012-09-01 00:00:00
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更新日期:2017-06-01 00:00:00
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更新日期:2013-03-01 00:00:00
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更新日期:2004-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
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更新日期:2011-05-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2002.03011.x
更新日期:2002-11-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00406.x
更新日期:2000-02-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00597.x
更新日期:2000-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-07-01 00:00:00
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journal_title:BJU international
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更新日期:2019-04-01 00:00:00