Salvage Cryosurgery for Recurrent Prostate Cancer After Radiation Therapy: A Seven-Year Follow-up

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

doi:10.3816/cgc.2003.n.018

Cited by 127 publications

(75 citation statements)

References 20 publications

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“…33 The 7-year actuarial biochemical control rates, stratified by PSA, were 61%, 62%, and 50% for PSA <4, 4-10, and >10, respectively. Results reported from the University of Calgary (n 5 46) used a PSA of 0.3 ng/mL to define biochemical control.…”

mentioning

confidence: 99%

Management of prostate cancer recurrences after radiation therapy‐brachytherapy as a salvage option

Allen

Howard

Jarrard

et al. 2007

Cancer

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Depending on initial prognostic factors, an estimated 10%-60% of men who undergo definitive radiation therapy for prostate cancer may experience a biochemical recurrence. Even though hormonal therapy is standard for metastatic recurrences, no consensus exists on optimal salvage therapy for those recurrences thought confined to the prostate. Salvage treatment options for these local recurrences have historically been limited to salvage prostatectomy, hormonal therapy, or cryotherapy. Salvage prostate brachytherapy, however, uses a widely available technique and may provide another option for attaining disease control in patients with localized failures, although only about 110 cases have been reported in the literature. In this report, the authors have described their own series of salvage brachytherapy cases as well as presented a review of other such series reported in the literature. In addition, the authors included a comprehensive review of published experiences with surgery and cryotherapy as salvage options. It appears that salvage brachytherapy, when combined with careful patient selection, is at least as effective as other salvage options with comparable or potentially fewer treatment-related side effects.

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confidence: 99%

Management of prostate cancer recurrences after radiation therapy‐brachytherapy as a salvage option

Allen

Howard

Jarrard

et al. 2007

Cancer

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“…The initial report is optimistic. The longest data were presented by Bahn et al 34 At 7 y, 59% of the patients were biochemically disease-free.…”

Section: Oncological Outcomementioning

confidence: 96%

“…Urinary incontinence rates have declined from 95% 26 to 8%. 34 The rates of incontinence have not changed after salvage prostatectomy despite modification of surgical technique ranging from 10 to 58%. 8,36 The most serious and challenging complication of cryotherapy is rectourethral fistula that is rarely seen nowadays.…”

Section: Morbiditymentioning

confidence: 99%

Salvage cryosurgery for locally recurrent prostate cancer following radiotherapy

Ahmed

Lindsey

Davies

2004

Prostate Cancer Prostatic Dis

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“…The second was the Phoenix criteria, which was defined as an increase of more than 2 ng mL −1 from the nadir level of PSA [14]. The third criterion was defined as an inability to achieve and maintain a PSA value of ≤ 0.5 ng mL −1 , which was suggested by Bahn et al [7]. Initiation of other anti-tumor treatments, including the reinitiation of ADT, was considered recurrence, regardless of PSA response.…”

Section: Study End Points and Statistical Analysismentioning

confidence: 99%

“…Compared with conventional surgical removal, CSAP allows for decreased hospitalization time, reduced postoperative morbidity, decreased interval for return to daily activities and reduced overall treatment cost [7][8][9]. Thus, particularly for patients with advanced age or significant comorbidities who prefer a proactive approach but are not considered good candidates for conventional surgery, CSAP can be an attractive alternative method of treatment.…”

Section: Introductionmentioning

confidence: 99%

The biochemical efficacy of primary cryoablation combined with prolonged total androgen suppression compared with radiotherapy on high-risk prostate cancer: a 3-year pilot study

Kang²,

Park³

et al. 2010

Asian J Androl

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To gain beneficial effects in the management of high-risk prostate cancer, an integrated approach that combines local therapy and androgen deprivation therapy (ADT) was used. We compared biochemical responses between primary cryosurgical ablation of the prostate (CSAP) combined with prolonged ADT and radiation combined with ADT, which is the established modality in high-risk disease. A total of 33 high-risk patients received CSAP combined with ADT for 3 months before and up to 24 months after treatment. This patient group was matched with another 33 patients who had undergone three-dimensional conformal radiation therapy (3D-CRT) with the same protocol for ADT. Biochemical recurrence (BCR) was assessed by the American Society for Therapeutic Radiation Oncology (ASTRO) definition, the Phoenix definition and a prostate-specific antigen (PSA) cutoff of 0.5 ng mL −1 . Median follow-up was 61.0 ± 11.9 months for the CSAP + ADT group and 86.0 ± 15.8 months for the 3D-CRT + ADT group. In the CSAP group, major complications including rectourethral fistula and incontinence were not noted. In the CSAP + ADT group, 57.0% had BCR using the ASTRO definition, 21.2% using the Phoenix definition and 54.5% using a PSA cutoff of 0.5 ng mL −1 . In the 3D-CRT + ADT group, 54.5%, 21.2% and 54.5% had BCR using the ASTRO, Phoenix and PSA definition, respectively. In the CSAP + ADT group, the BCR-free survival (BRFS) was 54 ± 10 months using the ASTRO definition, 65 ± 5 months using the Phoenix definition and 51 ± 4 months using a PSA cutoff of 0.5 ng mL −1 . In the 3D-CRT + ADT group, the BRFS was 68 ± 12, 93 ± 19 and 70 ± 18 months using the ASTRO, Phoenix and PSA definition, respectively. By the log-rank test, the BRFS values for each group were not statistically different. This intermediate-term result indicated that primary CSAP combined with prolonged ADT offers a parallel biochemical response compared with radiotherapy in high-risk prostate cancer.

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Salvage Cryosurgery for Recurrent Prostate Cancer After Radiation Therapy: A Seven-Year Follow-up

Cited by 127 publications

References 20 publications

Management of prostate cancer recurrences after radiation therapy‐brachytherapy as a salvage option

Management of prostate cancer recurrences after radiation therapy‐brachytherapy as a salvage option

Salvage cryosurgery for locally recurrent prostate cancer following radiotherapy

The biochemical efficacy of primary cryoablation combined with prolonged total androgen suppression compared with radiotherapy on high-risk prostate cancer: a 3-year pilot study

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