LOCAL TUMOR CONTROL WITH SALVAGE CRYOTHERAPY FOR LOCALLY RECURRENT PROSTATE CANCER AFTER EXTERNAL BEAM RADIOTHERAPY
2001; Lippincott Williams & Wilkins; Volume: 165; Issue: 3 Linguagem: Inglês
10.1016/s0022-5347(05)66546-9
ISSN1527-3792
AutoresJonathan I. Izawa, Paul Perrotte, Graham Greene, SHELLIE M. SCOTT, Lawrence B. Levy, Edward J. McGuire, Lydia T Madsen, Andrew C. von Eschenbach, Louis L. Pisters,
Tópico(s)Hepatocellular Carcinoma Treatment and Prognosis
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Mar 2001LOCAL TUMOR CONTROL WITH SALVAGE CRYOTHERAPY FOR LOCALLY RECURRENT PROSTATE CANCER AFTER EXTERNAL BEAM RADIOTHERAPY JONATHAN I. IZAWA, PAUL PERROTTE, GRAHAM F. GREENE, SHELLIE SCOTT, LAWRENCE LEVY, EDWARD McGUIRE, LYDIA MADSEN, ANDREW C. von ESCHENBACH, and LOUIS L. PISTERS JONATHAN I. IZAWAJONATHAN I. IZAWA , PAUL PERROTTEPAUL PERROTTE , GRAHAM F. GREENEGRAHAM F. GREENE , SHELLIE SCOTTSHELLIE SCOTT , LAWRENCE LEVYLAWRENCE LEVY , EDWARD McGUIREEDWARD McGUIRE , LYDIA MADSENLYDIA MADSEN , ANDREW C. von ESCHENBACHANDREW C. von ESCHENBACH , and LOUIS L. PISTERSLOUIS L. PISTERS View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66546-9AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We identified variables associated with a positive prostate biopsy after salvage cryotherapy in patients in whom initial external beam radiotherapy for prostate cancer failed to improve our cryotherapy technique, optimize local control and improve our patient selection criteria for salvage cryotherapy. Materials and Methods: Between July 1992 and January 1995, 145 patients underwent salvage cryotherapy. Post-cryotherapy sextant prostate biopsies were performed in 107 cases. We evaluated certain variables on univariate and multivariate analysis as predictors of a positive biopsy after cryotherapy, including the type of previous therapy, tumor stage and grade at initial diagnosis, prostate volume, pre-cryotherapy prostate specific antigen (PSA), number of positive biopsy cores before cryotherapy, PSA nadir after cryotherapy, stage and grade of local recurrence, number of cryoprobes, number of freeze-thaw cycles and use of a urethral warming catheter during cryotherapy. Results: Biopsies were positive in 23 cases (21%) after salvage cryotherapy. Variables associated with a positive biopsy on univariate analysis were initial stage, precryotherapy PSA, PSA nadir after cryotherapy, number of cryoprobes, number of freeze-thaw cycles and a history of chemotherapy (p = 0.005, 0.027, 0.001, 0.009, 0.018 and 0.008, respectively). Variables that remained associated with a positive biopsy on multivariate analysis were the number of probes used and post-cryotherapy PSA nadir (p = 0.013 and 0.019, respectively). Conclusions: Patients with initial clinical stage T1-2N0M0 disease and PSA no more than 10 ng./ml. have a higher rate of negative biopsies after salvage cryotherapy. Therefore, they are better candidates for salvage cryotherapy for locally recurrent prostate adenocarcinoma after external beam radiotherapy. To optimize the potential for local control the technique of salvage cryotherapy should include 2 freeze-thaw cycles and a minimum of 5 cryoprobes. Detectable PSA after salvage cryotherapy is a strong predictor of local failure. References 1 : Prostate rebiopsy is a poor surrogate of treatment efficacy in localized prostate cancer. J Urol1998; 159: 1606. Link, Google Scholar 2 : The efficacy and complications of salvage cryotherapy of the prostate. J Urol1997; 157: 921. 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Anderson Center, Houston, Texas© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by (2018) Reply by AuthorsJournal of Urology, VOL. 180, NO. 2, (564-564), Online publication date: 1-Aug-2008.Ng C, Moussa M, Downey D and Chin J (2018) Salvage Cryoablation of the Prostate: Followup and Analysis of Predictive Factors for OutcomeJournal of Urology, VOL. 178, NO. 4, (1253-1257), Online publication date: 1-Oct-2007.TOUMA N, IZAWA J and CHIN J (2018) CURRENT STATUS OF LOCAL SALVAGE THERAPIES FOLLOWING RADIATION FAILURE FOR PROSTATE CANCERJournal of Urology, VOL. 173, NO. 2, (373-379), Online publication date: 1-Feb-2005. Volume 165Issue 3March 2001Page: 867-870 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordssalvage therapylocalcryotherapyprostateneoplasm recurrenceprostatic neoplasmsMetricsAuthor Information JONATHAN I. IZAWA More articles by this author PAUL PERROTTE Current address: Department of Urology, University of Montreal, Montreal, Quebec, Canada. More articles by this author GRAHAM F. GREENE Current address: Department of Surgery, Division of Urology, University of Arkansas, Little Rock, Arkansas. More articles by this author SHELLIE SCOTT More articles by this author LAWRENCE LEVY More articles by this author EDWARD McGUIRE Current address: Department of Urology, University of Michigan, Ann Arbor, Michigan. Financial and/or other relationship with C. R. Bard. More articles by this author LYDIA MADSEN Financial and/or other relationship with Amgen More articles by this author ANDREW C. von ESCHENBACH More articles by this author LOUIS L. PISTERS Financial and/or other relationship with Introgen More articles by this author Expand All Advertisement PDF downloadLoading ...
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