Focal Prostate Cryoablation: Initial Results Show Cancer Control and Potency Preservation

Bahn, Duke; Silverman, Paul; Lee, Fred; Badalament, Robert A.; Bahn, Eric D.; Rewcastle, John C.

doi:10.1089/end.2006.20.688

Cited by 166 publications

(93 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a contemporary clinical series of unilateral cryoablation, selection criteria are mainly preoperative PSA, clinical stage, biopsy Gleason score and biopsy findings, regarding tumour involvement and the number of contiguous cores. 21,24 In some series, mandatory inclusion criteria are negative neurovascular bundle and seminal vesicle biopsies when extracapsular extension of the disease is suspected. 2 In a large study of 1114 patients with unilateral disease, based on the biopsy findings, the authors reported that the presence of HGPIN on biopsy significantly predicts contralateral prostate lobe involvement and should be considered an exclusion criterion for FT. 25 This was not the case in our study; HGPIN was not involved in the prediction of unilaterality after radical prostatectomy.…”

Section: Discussionmentioning

confidence: 99%

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates

Sfoungaristos

Perimenis

2013

CUAJ

View full text Add to dashboard Cite

E82Cite as: Can Urol Assoc J 2013;7:E82-E87. http://dx.doi.org/10.5489/cuaj.268. Epub 2011 November 2. AbstractBackground: Focal hemiablative therapy for prostate cancer is a new treatment alternative. Unilateral and unifocal disease are its main limitations. The aim of this study was to identify the epidemiological, clinical and pathological parameters that may predict unilateral disease in patients diagnosed with prostate cancer. Methods:We performed a retrospective analysis of patients at our institution between January 2005 and January 2011. Only patients with unilateral disease in prostate biopsy were part of the study. The analysis included age, preoperative prostate-specific antigen (PSA) and its density, prostate volume, biopsy first and second Gleason pattern and Gleason summary, number of biopsy cores, percentage of cancer in biopsy material and the presence of highgrade prostatic intraepithelial neoplasia. Their role as potential predictors was evaluated by univariate and multivariate analysis. Results: A total of 161 patients had unilateral disease after prostate biopsy. A significant correlation was found between prostate volume, PSA density and percentage of cancer in biopsy material and the presence of unilateral disease in the surgical specimen. These are the same factors significant in the univariate analysis. The results of the multivariate analysis demonstrated that PSA density (p = 0.015) and percentage of cancer in biopsy material (p = 0.028) are the most significant predictors. Interpretation: Our results demonstrate that PSA density and the percentage of cancer in biopsy cores are significant predictors for prostate cancer unilaterality and should be considered for the selection of hemiablative focal therapy candidates.

show abstract

Section: Discussionmentioning

confidence: 99%

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates

Sfoungaristos

Perimenis

2013

CUAJ

View full text Add to dashboard Cite

show abstract

“…49 A similar study reported a 96% negative biopsy rate, 93% free of biochemical recurrence, and 88.9% potency preservation. 48 A study of 60 FT cases reported similar figures. 47 An FLA trial fused 3D ultrasound with MR imaging to guide transperineal FLA in 12 patients, and temperature was monitored with fluoroptic probes.…”

Section: Dovepressmentioning

confidence: 72%

“…[47][48][49] Unilateral nerve sparing has been attempted, and data are now available for 48 patients followed for a mean of 4.5 years. Stable PSA was reported in 94% of patients, and of the 24 patients biopsied regularly, there was no evidence of local recurrence in the treated area.…”

Section: Ft Strategies and Resultsmentioning

confidence: 99%

The new era of minimally invasive interventions for prostate cancer: robot-assisted laparoscopic radical prostatectomy and focal therapy

Schatloff¹,

Louis²,

Lindner³

2011

OAS

View full text Add to dashboard Cite

Prostate cancer remains a common but highly treatable disease. Innovations in prostate cancer treatment have allowed a transition toward minimally invasive approaches in an attempt to avoid treatment-related morbidities. In the middle of the treatment spectrum between radical open surgeries and active surveillance lies robot-assisted laparoscopic radical prostatectomy (RALP) and focal therapy (FT). This review sets out the most current information on RALP and FT (including laser ablation, cryotherapy, high-intensity focused ultrasound, photodynamic therapy, and irreversible electroporation).

show abstract

“…Those that support focal therapy demonstrate that only a few men would have been undertreated when radical prostatectomy would have been curative. 113,[115][116][117][118][119] Those against focal therapy argue that, even using stringent selection criteria, 20% of the men who would have undergone focal cryotherapy would have had potentially significant prostate cancer that was not adequately treated. 119 In a study looking at 100 completely embedded radical prostatectomy specimens in which the previous needle biopsies predicted limited disease (fewer than 3 positive cores, 50% or less involvement of any positive core, Gleason score 6/grade group 1, and all unilateral positive cores) in 65% of cases, there was some tumor contralateral to the positive biopsy side in the radical prostatectomy specimens.…”

Section: Cryotherapy For Prostate Cancermentioning

confidence: 99%

Biomarker, Molecular, and Technologic Advances in Urologic Pathology, Oncology, and Imaging

Ellis

Harik

Cohen

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

View full text Add to dashboard Cite

Urologic pathology is evolving rapidly. Emerging trends include the expanded diagnostic utility of biomarkers and molecular testing, as well as adapting to the plethora of technical advances occurring in genitourinary oncology, surgical practice, and imaging. We illustrate those trends by highlighting our approach to the diagnostic workup of a few selected disease entities that pathologists may encounter, including newly recognized subtypes of renal cell carcinoma, pheochromocytoma, and prostate cancer, some of which harbor a distinctive chromosomal translocation, gene loss, or mutation. We illustrate applications of immunohistochemistry for differential diagnosis of needle core renal biopsies, intraductal carcinoma of the prostate, and amyloidosis and cite encouraging results from early studies using targeted gene expression panels to predict recurrence after prostate cancer surgery. At our institution, pathologists are working closely with urologic surgeons and interventional radiologists to explore the use of intraoperative frozen sections for margins and nerve sparing during robotic prostatectomy, to pioneer minimally invasive videoscopic inguinal lymphadenectomy, and to refine image-guided needle core biopsies and cryotherapy of prostate cancer as well as blue-light/fluorescence cystoscopy. This collaborative, multidisciplinary approach enhances clinical management and research, and optimizes the care of patients with urologic disorders. (Arch Pathol Lab Med. 2017;141:499-516; doi: 10.5858.arpa.2016-0263-SA) I n this review, we summarize the effect of a number of biomarker, molecular, and technologic advances in urologic pathology, oncology, and imaging on routine, day-to-day practice and research at our institution. The objective of this review is not to cover the entire gamut of all advances that we have and use at our institution but, rather, to highlight a few pertinent concepts in our field. Topics that will be covered include biomarkers, molecular testing of selected malignancies (eg, transcription factor E3 [TFE3]/ Xp11.2 translocation-associated renal cell carcinoma; p63, high-molecular-weight cytokeratin and racemase cocktail [PIN4]/phosphatase and tensin homolog [PTEN] for some cases of intraductal carcinoma of the prostate; and succinate dehydrogenase subunit B in renal cell carcinoma and pheochromocytoma), amyloidosis of the genitourinary tract, and workup of neoplastic needle core kidney biopsies. In addition, we will report the effect of pathologic, oncologic, and radiologic technologic advances (ie, global transcriptome analysis and RNA biomarkers of prostate cancer; robotic-assisted radical prostatectomy; minimally invasive videoscopic inguinal lymphadenectomy; targeted magnetic resonance imaging [MRI]-guided prostate needle core biopsies; anti-1-amino-3-fluorine 18-fluorocyclobutane-1-carboxylic acid in prostate cancer; cryotherapy for prostate cancer; and blue-light/white-light cystoscopy for bladder lesions) performed at our institution.

show abstract

Focal Prostate Cryoablation: Initial Results Show Cancer Control and Potency Preservation

Abstract: Focal cryoablation can provide biochemical and local control of prostate cancer while preserving potency and continence. Further investigation is needed.

Cited by 166 publications

References 29 publications

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates

Parameters predicting postoperative unilateral disease in patients with unilateral prostate cancer in diagnostic biopsy: a rationale for selecting hemiablative focal therapy candidates

The new era of minimally invasive interventions for prostate cancer: robot-assisted laparoscopic radical prostatectomy and focal therapy

Biomarker, Molecular, and Technologic Advances in Urologic Pathology, Oncology, and Imaging

Contact Info

Product

Resources

About