Indian Journal of Urology Users online:176  
IJU
Home Current Issue Ahead of print Editorial Board Archives Symposia Guidelines Subscriptions Login 
Print this page  Email this page Small font sizeDefault font sizeIncrease font size
ORIGINAL ARTICLE
Year : 2008  |  Volume : 24  |  Issue : 4  |  Page : 490-493

Primary cryoablation for Gleason 8, 9, or 10 localized prostate cancer: Biochemical and local control outcomes from the Cryo OnLine database registry


1 Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
2 Department of Radiology, University of Calgary, Calgary, AB, Canada

Correspondence Address:
J Stephen Jones
Glickman Urological Institute, Cleveland Clinic Foundation, A-100, 9500 Euclid Ave., Cleveland, OH 44195, USA

Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.44254

Rights and Permissions

Introduction and Objective: The increased use of cryoablation as an initial treatment for localized high-grade prostate cancer has been due to many factors including reports that cell kill from exposure to cryogenic temperatures is independent of cellular dedifferentiation and Gleason score. The objective of this study is to report the outcomes of primary cryoablation when used to treat Gleason 8, 9, or 10 localized prostate cancer at a large number of centers. Materials and Methods: Data from 1608 patients who underwent primary cryoablation at 27 centers were collected using the Cryo OnLine Database (COLD) registry. This analysis considers only the 77 patients who had a Gleason score of at least 8 and a minimum of 24 months of follow-up. Biochemical failure was defined according to both the original ASTRO definition (three rises) and the 2006 updated ASTRO (Phoenix) definition of nadir + 2. Biopsy was performed at the physician's discretion, but most commonly if a patient had a rising or suspicious prostate specific antigen (PSA). Results: The average age at treatment was 69.6 8.2 years. Pretreatment PSA was 16.2 17.9 ng/ml and the average Gleason was 8.5 0.6. Patients were followed for 39.0 18.8 months (range: 24-120 months) and 5-year follow-up was available for 12 patients. Eight-seven percent of the patients achieved a PSA nadir < 0.4 ng/ml. Five-year actuarial biochemical survivals was 64.4 6.0% and 44.6 8.0% for the ASTRO and Phoenix definitions, respectively. A total of 47 underwent posttreatment biopsy. Of these, 12 showed evidence of disease resulting in a positive biopsy rate for those who underwent biopsy of 25.5%. This yields a positive biopsy rate of the entire population of 15.6% (12/77). Conclusions: Cryoablation, as a primary treatment for high-grade Gleason prostate cancer practiced over a wide spectrum of users provides definable biochemical and local control for a hard to manage patient population with aggressive disease.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed9335    
    Printed83    
    Emailed1    
    PDF Downloaded144    
    Comments [Add]    
    Cited by others 1    

Recommend this journal

 

HEALTHWARE INDIA