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Incomplete glandular ablation after salvage cryotherapy for recurrent prostate cancer after radiotherapy

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Title: Incomplete glandular ablation after salvage cryotherapy for recurrent prostate cancer after radiotherapy
Authors: Izawa, Jonathan I.1, Morganstern, Nora2, Chan, Deva M.1, Levy, Lawrence B.3, Scott, Shellie M.1, Pisters, Louis L.1 lpisters@mail.mdanderson.org
Source: International Journal of Radiation Oncology, Biology, Physics. Jun2003, Vol. 56 Issue 2, p468-472. 5p.
Subjects: Cold therapy, Prostate cancer, Biopsy, Evaluation research, Cancer relapse, Prostate-specific antigen, Research funding, Salvage therapy, Prostate tumors, Cryosurgery, Prostate, Analysis of variance, Research methodology, Research, Prognosis, Comparative studies, Regression analysis, Impact of Event Scale
Abstract: : PurposeTo determine the clinical variables associated with inadequate salvage cryotherapy and to correlate the disease-free survival rates associated with biopsy results in prostate cancer (CaP).: Methods and materialsBetween July 1992 and January 1995, 150 patients underwent salvage cryotherapy for locally recurrent CaP. Biopsy specimens were examined for the presence of cancer cells and normal or atypical glands, all of which were considered evidence of inadequate cryotherapy. Clinical variables, as predictors of biopsy results, were evaluated with univariate and multivariate analyses. The impact of the biopsy results on disease-free survival was also determined.: ResultsThe number of cryoprobes and freeze-thaw cycles correlated with inadequate cryotherapy (p = 0.037 and p = 0.0022, respectively). The number of freeze-thaw cycles was an independent predictor of inadequate cryotherapy (p = 0.003). The finding of cancer cells in the biopsy specimens was the only histopathologic variable that affected disease-free survival (p = 0.016).: ConclusionComplete ablation of the prostate gland and tumor is difficult to achieve with salvage cryotherapy. To optimize for complete ablation, salvage cryotherapy should include at least two freeze-thaw cycles and a minimum of five cryoprobes. The finding of atypical or normal epithelial tissue in biopsy specimens after salvage cryotherapy is not predictive of biochemical failure. [Copyright &y& Elsevier]
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Abstract:: PurposeTo determine the clinical variables associated with inadequate salvage cryotherapy and to correlate the disease-free survival rates associated with biopsy results in prostate cancer (CaP).: Methods and materialsBetween July 1992 and January 1995, 150 patients underwent salvage cryotherapy for locally recurrent CaP. Biopsy specimens were examined for the presence of cancer cells and normal or atypical glands, all of which were considered evidence of inadequate cryotherapy. Clinical variables, as predictors of biopsy results, were evaluated with univariate and multivariate analyses. The impact of the biopsy results on disease-free survival was also determined.: ResultsThe number of cryoprobes and freeze-thaw cycles correlated with inadequate cryotherapy (p = 0.037 and p = 0.0022, respectively). The number of freeze-thaw cycles was an independent predictor of inadequate cryotherapy (p = 0.003). The finding of cancer cells in the biopsy specimens was the only histopathologic variable that affected disease-free survival (p = 0.016).: ConclusionComplete ablation of the prostate gland and tumor is difficult to achieve with salvage cryotherapy. To optimize for complete ablation, salvage cryotherapy should include at least two freeze-thaw cycles and a minimum of five cryoprobes. The finding of atypical or normal epithelial tissue in biopsy specimens after salvage cryotherapy is not predictive of biochemical failure. [Copyright &y& Elsevier]
ISSN:03603016
DOI:10.1016/S0360-3016(02)04574-1