1. Cryotherapy for partial gland ablation of prostate cancer: Oncologic and safety outcomes
- Author
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Aker, Mamdouh N, Brisbane, Wayne G, Kwan, Lorna, Gonzalez, Samantha, Priester, Alan M, Kinnaird, Adam, Delfin, Merdie K, Felker, Ely, Sisk, Anthony E, Kuppermann, David, and Marks, Leonard S
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Clinical Research ,Prostate Cancer ,Clinical Trials and Supportive Activities ,Urologic Diseases ,Cancer ,Aging ,Male ,Humans ,Prostate-Specific Antigen ,Prospective Studies ,Prostatic Neoplasms ,Cryotherapy ,Image-Guided Biopsy ,Magnetic Resonance Imaging ,Prostate cancer ,cryotherapy ,focal therapy ,Biochemistry and Cell Biology ,Oncology and carcinogenesis - Abstract
BackgroundPartial gland ablation (PGA) is a new option for treatment of prostate cancer (PCa). Cryotherapy, an early method of PGA, has had favorable evaluations, but few studies have employed a strict protocol using biopsy endpoints in men with clinically significant prostate cancer (csPCa).Methods143 men with unilateral csPCa were enrolled in a prospective, observational trial of outpatient PGA-cryotherapy. Treatment was a 2-cycle freeze of the affected prostate part. Participants were evaluated with MRI-guided biopsy (MRGB) at baseline and at 6 months and 18 months after treatment. Absence of csPCa upon MRGB was the primary endpoint; quality-of-life at baseline and at 6 months after treatment was assessed by EPIC-CP questionnaires in the domains of urinary and sexual function.ResultsOf the 143 participants, 136 (95%) completed MRGB at 6 months after treatment. In 103/136 (76%), the biopsy revealed no csPCa. Of the 103, 71 subsequently had an 18-month comprehensive biopsy; of the 71 with 18-month biopsies, 46 (65%) were found to have no csPCa. MRI lesions became undetectable in 96/130 (74%); declines in median serum PSA levels (6.9 to 2.5 ng/mL), PSA density (0.15 to 0.07), and prostate volume (42 to 34cc) were observed (all p
- Published
- 2023