Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging
Abstract Background Due to their location away from the nerve bundles, anterior prostate cancers (APC) represent a rational target for image-guided cryoablation. This report describes the feasibility and short-term outcomes of anterior focal cryosurgery. Methods A retrospective review between 2012 a...
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doaj-fedd05a81aaa4050b92c232482a478f62020-12-06T12:28:34ZengBMCBMC Urology1471-24902019-12-011911710.1186/s12894-019-0562-5Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imagingChristina Sze0Efrat Tsivian1Kae Jack Tay2Ariel A. Schulman3Leah G. Davis4Rajan T. Gupta5Thomas J. Polascik6Urologic Surgery, Duke University Medical Center and the Duke Cancer InstituteUrologic Surgery, Duke University Medical Center and the Duke Cancer InstituteUrologic Surgery, Duke University Medical Center and the Duke Cancer InstituteUrologic Surgery, Duke University Medical Center and the Duke Cancer InstituteUrologic Surgery, Duke University Medical Center and the Duke Cancer InstituteUrologic Surgery, Duke University Medical Center and the Duke Cancer InstituteUrologic Surgery, Duke University Medical Center and the Duke Cancer InstituteAbstract Background Due to their location away from the nerve bundles, anterior prostate cancers (APC) represent a rational target for image-guided cryoablation. This report describes the feasibility and short-term outcomes of anterior focal cryosurgery. Methods A retrospective review between 2012 and 2016 of patients with clinically localized APC treated with anterior gland cryoablation was performed. Descriptive statistics were used to report: age, PSA, prostate volume, prostate cancer grade group (PGG), median time to follow-up, and changes in functional status measured with the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF-5) score. Results A total of 17 patients underwent anterior focal cryoablation with a median follow-up of 15 months. Median age and PSA at diagnosis were 67 years and 8.7 ng/mL. Pre-operative PGG1 was identified in 12 (71%) men and PGG2 in 5 (29%) men. Median (IQR) lesion volume was 2 mL(0.86, 3.1). Preoperative median IIEF-5 and IPSS scores were 19.5 and 5, and decreased to 19 and 4, post-operatively. All patients remained continent with no change in sexual function. All post-procedure targeted biopsies of the treated cancers were negative. Conclusion Our pilot study demonstrates the feasibility of treating APCs with image-guided targeted focal cryoablation as a good balance between short-term oncologic control and near complete preservation of genitourinary function. Further follow-up is necessary to examine the potential benefits long-term.https://doi.org/10.1186/s12894-019-0562-5Focal cryoablationAnterior glandProstate cancerErectile functionContinence |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Christina Sze Efrat Tsivian Kae Jack Tay Ariel A. Schulman Leah G. Davis Rajan T. Gupta Thomas J. Polascik |
spellingShingle |
Christina Sze Efrat Tsivian Kae Jack Tay Ariel A. Schulman Leah G. Davis Rajan T. Gupta Thomas J. Polascik Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging BMC Urology Focal cryoablation Anterior gland Prostate cancer Erectile function Continence |
author_facet |
Christina Sze Efrat Tsivian Kae Jack Tay Ariel A. Schulman Leah G. Davis Rajan T. Gupta Thomas J. Polascik |
author_sort |
Christina Sze |
title |
Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging |
title_short |
Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging |
title_full |
Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging |
title_fullStr |
Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging |
title_full_unstemmed |
Anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging |
title_sort |
anterior gland focal cryoablation: proof-of-concept primary prostate cancer treatment in select men with localized anterior cancers detected by multi-parametric magnetic resonance imaging |
publisher |
BMC |
series |
BMC Urology |
issn |
1471-2490 |
publishDate |
2019-12-01 |
description |
Abstract Background Due to their location away from the nerve bundles, anterior prostate cancers (APC) represent a rational target for image-guided cryoablation. This report describes the feasibility and short-term outcomes of anterior focal cryosurgery. Methods A retrospective review between 2012 and 2016 of patients with clinically localized APC treated with anterior gland cryoablation was performed. Descriptive statistics were used to report: age, PSA, prostate volume, prostate cancer grade group (PGG), median time to follow-up, and changes in functional status measured with the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF-5) score. Results A total of 17 patients underwent anterior focal cryoablation with a median follow-up of 15 months. Median age and PSA at diagnosis were 67 years and 8.7 ng/mL. Pre-operative PGG1 was identified in 12 (71%) men and PGG2 in 5 (29%) men. Median (IQR) lesion volume was 2 mL(0.86, 3.1). Preoperative median IIEF-5 and IPSS scores were 19.5 and 5, and decreased to 19 and 4, post-operatively. All patients remained continent with no change in sexual function. All post-procedure targeted biopsies of the treated cancers were negative. Conclusion Our pilot study demonstrates the feasibility of treating APCs with image-guided targeted focal cryoablation as a good balance between short-term oncologic control and near complete preservation of genitourinary function. Further follow-up is necessary to examine the potential benefits long-term. |
topic |
Focal cryoablation Anterior gland Prostate cancer Erectile function Continence |
url |
https://doi.org/10.1186/s12894-019-0562-5 |
work_keys_str_mv |
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