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Cryotherapy for low risk prostate cancer, oncological and functional medium term outcomes: A three center prospective study

Valerian Ciprian Lucan, Franco Lugnani, Salvatore Butticè, Emre Sener, Christopher Netsch, Michele Talso, Francesco Cantiello, Rosa Pappalardo, Carlo Magno
  • Valerian Ciprian Lucan
    Clinical Institute of Urology and Renal Transplants, Cluj-Napoca, Romania
  • Franco Lugnani
    Unit of Urology, Kirurski Sanatorij Ljubljana, Slovenia
  • Salvatore Butticè
    Department of Human Pathology - Section of Urology, University of Messina, Italy | salvobu@gmail.com
  • Emre Sener
    Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey
  • Christopher Netsch
    Department of Urology, Asklepios Hospital Barmbek, Hamburg, Germany
  • Michele Talso
    Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Italy
  • Francesco Cantiello
    Department of Urology, Magna Graecia University, Catanzaro, Italy
  • Rosa Pappalardo
    Department of Human Pathology - Section of Urology, University of Messina, Italy
  • Carlo Magno
    Department of Human Pathology - Section of Urology, University of Messina, Italy

Abstract

Objectives: Analyze the oncologic and functional outcomes in patients affected by low risk prostate cancer underwent prostate cryotherapy. Materiasl and methods: It’s a prospective tricentric study of 434 patients treated with prostate cryoablation for low risk prostate cancer. By low risk we refer to the D'Amico’s risk classification. Two cycles of freezing/thawing are run for each patient following the technique described by Onik. Results: For the 434 patients, the median age was 66 years with a standard deviation of ± 6.68, the average PSA was 6.17 ng/d/L, the median 5.55 with a standard deviation of ± 2.13, the mean prostate volume was 35.59 cc, the median 34.00 cc, with a standard deviation of ± 7.89. Biochemical failure occurred in 67 patients (15.4%). Pre-operative erectile function in men was distributed as follows: severe in 95 patients (19.2%), moderate in 95 (19.2%), medium-moderate in 180 (36.4%), mild in 92 (18.6%), with no dysfunction in 32 (6.5%) patients. Post-operative erectile function, measured 1 month after cryotherapy, was distributed as follows: severe in 321 (65%) patients, moderate in 69 (14%), medium-moderate in 79 (16%), mild in 23 (4.7%), and no dysfunction in only 2 patients (0.4%). Post-operative erectile function after 3 months was distributed as follows: severe in 233 (47.2%) patients, moderate in 66 (13.4%), medium-moderate in 122 (24.7%), mild in 65 (13.2%), and no dysfunction in 8 patients (1.6%). Urinary incontinence was present in 21 patients (4.8%) after 3 months while it dropped to 13 patients (2.9%) after 6 months. Conclusions: Cryotherapy in the treatment of prostate cancer remains a viable alternative. The availability of new cryoprobes and the use of new diagnostic means such as fusion magnetic resonance will make this more precise and more effective method.

Keywords

Prostate cryotherapy; Minimally invasive treatment; Focal therapy; Low risk prostate cancer

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Submitted: 2017-01-02 18:39:20
Published: 2017-06-30 00:00:00
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Copyright (c) 2017 Valerian Ciprian Lucan, Franco Lugnani, Salvatore Butticè, Emre Sener, Christopher Netsch, Michele Talso, Francesco Cantiello, Rosa Pappalardo, Carlo Magno

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