Surgery of prostatic carcinoma

Flocks, R.H.; O'donoghue, E. P. N.; Milleman, Leo A.; Culp, David A.

doi:10.1002/1097-0142(197508)36:2+<705::aid-cncr2820360815>3.0.co;2-#

Cited by 23 publications

(7 citation statements)

References 35 publications

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“…16 Flocks et al reported 15-year survival rates of 13% for patients who had LNI (with or without SVI) and for patients who underwent with local excision of the tumor plus interstitial 198 Au implantation. 17,18 Contemporary studies focusing on cancer survival in men with SVI in the PSA era are lacking. To address this issue, we analyzed a consecutive cohort of 387 men with clinically localized prostate cancer in whom invasion of the SV was noted after RP.…”

Section: Discussionmentioning

confidence: 99%

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Secín

Bianco

Vickers

et al. 2006

Cancer

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BACKGROUNDThe objectives of the current study were to determine the long‐term biochemical recurrence (BCR) and cancer‐specific survival (CSS) rates for men with seminal vesicle invasion (SVI) and to identify risk factors for freedom from BCR and CSS in patients who received treatment in the prostate‐specific antigen era and who had SVI identified at the time of radical prostatectomy (RP).METHODSProspective clinical, pathologic, and outcome data were collected for 5377 men who underwent RP between June 1983 and August 2004. There were 936 patients who were excluded because they received treatment before RP. Multivariable analysis was used to identify the factors that predicted BCR and CSS.RESULTSAmong 4441 eligible patients, 387 patients (8.7%) had SVI, and 91 of those 387 patients (24%) had lymph node involvement (LNI). In total, 210 patients experienced BCR. For patients without LNI, the 10‐year and 15‐year freedom from BCR rates were 36% and 32%, respectively, and the corresponding CSS rates were 89% and 81%, respectively. For the 91 men who had SVI and LNI, the 10‐year BCR‐free probability was 10%, but the 10‐year CSS probability was 74%. By 10 years, patients with LNI were 3 times more likely to die from cancer than from other causes; nonetheless, 66% of patients were alive despite their advanced stage. The preoperative prostate‐specific antigen level, extracapsular extension, LNI, and Gleason grade were associated independently with BCR. Gleason scores of 8 to 10 and LNI were significant predictors of CSS.CONCLUSIONSSVI does not invariably signal BCR or death from cancer in patients who undergo RP and pelvic lymph node dissection. Fifteen years later, approximately 33% of men with SVI and negative lymph nodes are expected remain free of BCR, and CSS was surprisingly good. Cancer 2006. © 2006 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Secín

Bianco

Vickers

et al. 2006

Cancer

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“…In 2008, an estimated 186 320 men will be diagnosed with prostate cancer and 28 660 men will die of this disease [1]. Two forms of therapy for treating patients with localized prostate cancer are surgery [2] and radiation therapy [3]. Both therapies have undergone significant technical developments during the last ten years and can be delivered in various ways.…”

Section: Introductionmentioning

confidence: 99%

Prostate Cryotherapy Monitoring Using Vibroacoustography: Preliminary Results of an Ex Vivo Study and Technical Feasibility

Mitri

Davis

Alizad

et al. 2008

IEEE Trans. Biomed. Eng.

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The objective of this research is to prospectively evaluate the feasibility of vibroacoustography (VA) imaging in monitoring prostate cryotherapy in an ex vivo model. Baseline scanning of an excised human prostate is accomplished by a VA system apparatus in a tank of degassed water. Alcohol and dry ice mixture are used to freeze two prostate tissue samples. The frozen prostates are subsequently placed within the water tank at 27°C and rescanned. VA images were acquired at prescribed time intervals to characterize the acoustic properties of the partially frozen tissue. The frozen prostate tissue appears in the images as hypoemitting signal. Once the tissue thaws, previously frozen regions show coarser texture than prior to freezing. The margin of the frozen tissue is delineated with a welldefined rim. The thawed cryolesions show a different contrast compared with normal unfrozen prostate. In conclusion, this pilot study shows that VA produces clear images of a frozen prostate at different temperature stages. The frozen tissue appears as a uniform region with well-defined borders that are readily identified. These characteristic images should allow safer and more efficient application of prostatic cryosurgery. These results provide substantial motivation to further investigate VA as a potential modality to monitor prostate cryotherapy intraoperatively.

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“…The animal model suffers from being dissimilar to the clinical In vivo evaluation situation but the results in vivo showed that even when the cryoprobe was placed directly on the urethra, there Figure 5 shows an ice-ball surrounding the urethra after 5 min of freezing without the warming catheter, and was no urethral mucosal necrosis. In the past, the complication rate of open transperi-these complications have occurred, probably because this catheter conforms better to the contour of neal cryosurgery was high, with a reported incidence of recto-urethral fistulae of 0.7 [16,17] to 1.4% [18,19] the prostatic urethra and/or has better heat-transfer properties than do other devices used in the reported and urethrocutaneous fistulae of 10.7% [20,21] to 14% [17,20,21]. Despite the use of TRUS for a more precise series.…”

Section: Resultsmentioning

confidence: 99%

In vitro and in vivo assessment of urethral warming catheters for the transperineal cryoablation of prostatic carcinoma

Cozzi¹,

Lynch²,

Robson³

et al. 1996

British Journal of Urology

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Objective To evaluate the two most common urethral warming catheters currently available for their effectiveness in preventing urethral injury in an animal model and thus during transperineal cryosurgery for the treatment of prostate cancer. Patients, materials and methods The warming efficiency of the variable‐diameter thin latex‐balloon catheter (Cook, Australia) and the fixed‐diameter PVC catheter (Candela, USA) were evaluated in a water‐bath. A sheep model was then used for subsequent experiments to further evaluate the better catheter. The technique used for the insertion of the Cook catheter in a series of 33 patients treated with prostate cryosurgery is also described. Results In vitro, the Cook catheter was more effective (P<0.01) than the Candela catheter in preventing localized cooling. In vivo, results in five animals showed that the urethral epithelium was viable in all sections that had been protected by the catheter and focally denuded or necrotic in those sections not protected, with each animal used as its own control (P<0.01 Fisher's exact test). The 33 patients treated while using the Cook catheter had no subsequent complications. Conclusion The urethral warming catheter currently in use for prostatic cryosurgery in Australia is more effective in vitro than its competitor and is effective in preventing urethral injury in vivo.

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Surgery of prostatic carcinoma

Cited by 23 publications

References 35 publications

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Cancer‐specific survival and predictors of prostate‐specific antigen recurrence and survival in patients with seminal vesicle invasion after radical prostatectomy

Prostate Cryotherapy Monitoring Using Vibroacoustography: Preliminary Results of an Ex Vivo Study and Technical Feasibility

In vitro and in vivo assessment of urethral warming catheters for the transperineal cryoablation of prostatic carcinoma

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