1. [Percutaneous MR-guided prostate cancer cryoablation: Predictive factors and oncologic outcomes].
- Author
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Gaullier M, Tricard T, Garnon J, Cazzato RL, Munier P, De Marini P, Werle P, Lindner V, Gangi A, and Lang H
- Subjects
- Aged, Biopsy, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasm Grading, Neoplasm Recurrence, Local, Predictive Value of Tests, Prostatic Neoplasms diagnostic imaging, Prostatic Neoplasms pathology, Retrospective Studies, Tumor Burden, Cryosurgery methods, Magnetic Resonance Imaging, Prostatic Neoplasms surgery
- Abstract
Objective: To determine the pejorative predictive factors on oncologic outcomes of percutaneous MR-guided whole gland prostate cancer cryoablation (CA)., Methods: Medical records of patients treated from 2009 to 2012, to assess medium-term oncologic outcomes, were reviewed. Prostate biopsies were performed in local recurrence suspicion (biochemical failure, MR follow-up failure)., Results: Among 18 patients, mean age of 72.6 (61-78), 2 (11 %) and 7 (38.9 %) biological and reported biopsy-proven local recurrence respectively with our initial technic of CA. Mean follow-up and recurrence were 56.3 (±21.7) and 20.7 (±13.9) months respectively. A previous treatment of prostate cancer (P=0.5), pre-treatment PSA (P=0.2), pre-treatment Gleason/ISUP score (P=0.4), nadir PSA post-CA (P=0.22) were not associated with recurrence. Bilateral positive cores appears as a pejorative predictive factor (P=0.04). However mean pre-treatment positive cores percentage, 25 (±16.5) in responding patients versus 40.7 (±25.2) in case of recurrence, and maximum percentage of cancer extent in each positive core, 10.6 (±9.3) in responding patients versus 18.7 (±16.5) in case of recurrence, seemed associated with local recurrence after prostate CA but our analysis wasn't able to find a difference (P=0.09 and P=0.3 respectively) due to a lack of power., Conclusion: Bilateral positive cores appears as a pejorative predictive factor. In our experience, important tumor volume seem to be a pejorative predictive factor for oncologic outcomes after PCA whereas treatment, PSA, Gleason/ISUP score, nadir PSA are not., Level of Evidence: 4., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)
- Published
- 2020
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