Cryotherapy for low risk prostate cancer, oncological and functional medium term outcomes: A three center prospective study

  • Valerian Ciprian Lucan Clinical Institute of Urology and Renal Transplants, Cluj-Napoca, Romania.
  • Franco Lugnani Unit of Urology, Kirurski Sanatorij Ljubljana, Slovenia.
  • Salvatore Butticè | salvobu@gmail.com Department of Human Pathology - Section of Urology, University of Messina, Italy.
  • Emre Sener Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey.
  • Christopher Netsch Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany.
  • Michele Talso Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Italy.
  • Francesco Cantiello Department of Urology, Magna Graecia University, Catanzaro, Italy.
  • Rosa Pappalardo Department of Human Pathology - Section of Urology, University of Messina, Italy.
  • Carlo Magno Department of Human Pathology - Section of Urology, University of Messina, Italy.

Abstract

Objectives: Analyze the oncologic and functional outcomes in patients affected by low risk prostate cancer underwent prostate cryotherapy. Materiasl and methods: It’s a prospective tricentric study of 434 patients treated with prostate cryoablation for low risk prostate cancer. By low risk we refer to the D'Amico’s risk classification. Two cycles of freezing/thawing are run for each patient following the technique described by Onik. Results: For the 434 patients, the median age was 66 years with a standard deviation of ± 6.68, the average PSA was 6.17 ng/d/L, the median 5.55 with a standard deviation of ± 2.13, the mean prostate volume was 35.59 cc, the median 34.00 cc, with a standard deviation of ± 7.89. Biochemical failure occurred in 67 patients (15.4%). Pre-operative erectile function in men was distributed as follows: severe in 95 patients (19.2%), moderate in 95 (19.2%), medium-moderate in 180 (36.4%), mild in 92 (18.6%), with no dysfunction in 32 (6.5%) patients. Post-operative erectile function, measured 1 month after cryotherapy, was distributed as follows: severe in 321 (65%) patients, moderate in 69 (14%), medium-moderate in 79 (16%), mild in 23 (4.7%), and no dysfunction in only 2 patients (0.4%). Post-operative erectile function after 3 months was distributed as follows: severe in 233 (47.2%) patients, moderate in 66 (13.4%), medium-moderate in 122 (24.7%), mild in 65 (13.2%), and no dysfunction in 8 patients (1.6%). Urinary incontinence was present in 21 patients (4.8%) after 3 months while it dropped to 13 patients (2.9%) after 6 months. Conclusions: Cryotherapy in the treatment of prostate cancer remains a viable alternative. The availability of new cryoprobes and the use of new diagnostic means such as fusion magnetic resonance will make this more precise and more effective method.

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Published
2017-06-30
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Section
Original Papers - Oncology
Keywords:
Prostate cryotherapy, Minimally invasive treatment, Focal therapy, Low risk prostate cancer
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How to Cite
Lucan, V. C., Lugnani, F., Butticè, S., Sener, E., Netsch, C., Talso, M., Cantiello, F., Pappalardo, R., & Magno, C. (2017). Cryotherapy for low risk prostate cancer, oncological and functional medium term outcomes: A three center prospective study. Archivio Italiano Di Urologia E Andrologia, 89(2), 97-101. https://doi.org/10.4081/aiua.2017.2.97

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