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Original Article
Nerve-Sparing Cryoablation for the Treatment of Primary Prostate Cancer: the Preliminary Report - Seong Choi
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Kosin Medical Journal 2014;29(2):135-140.
DOI: https://doi.org/10.7180/kmj.2014.29.2.135
Published online: December 18, 2014
1Deparment of Urology, College of Medicine, Kosin University, Busan, Korea
- Corresponding Author : Seong Choi, Department of Urology, College of Medicine, Kosin University, 262, Kamcheon-ro, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6253 FAX: +82-51-990-3994 E-mail: schoi@ns.kosinmed.or.kr
• Received: August 21, 2013 • Accepted: December 16, 2013
Copyright © 2014 Kosin University School of Medicine Proceedings
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
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Background:
- To present a pilot study of nerve-sparing cryoablation for the treatment of primary prostate cancer. Materials and Methods: Between 2008 and 2011, 9 patients underwent nerve-sparing cryoablation (unilateral 5, bilateral 4 patients). One neurovascular bundle (NVB) was spared on the side opposite the positive biopsy, and two NVBs were spared when indicated and possible. Just before the start of freezing, a 22-gauge spinal needle was placed into Denonvilliers fascia using a transperineal route, and normal saline was injected to separate the rectum from the prostate. The prostate-specific antigen (PSA) level was sampled every 3 months for the first 2 years and then every 6 months thereafter. Patients were considered to have a stable PSA if they had two consecutive PSA measurements without a rise.
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Results:
- The follow-up was 4ᄋ-months (19-66 months). All patients had stable PSA levels at last follow-up. Potency (defined as an erection sufficient to complete intercourse to the satisfaction of the patient) was maintained in 4 of 9 patients, 5 were potent with phosphodiesterase 5 inhibitors or intracavernosal injection. Conclusions: Nerve-sparing cryoablation, in which one or two neurovascular bundle is spared, showed the possibility of preserving potency in most patients without compromising cancer control. These preliminary results warrant further study.
Table 1.Patient characteristics
- 1.Walsh PC, and Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982;128:492–5.ArticlePubMed
- 2.Talcott JA, Reiker P, Propert KJ, Clark JA, Wishnow KI, Loughlin KR, et al. Patient reported impotence and incontinence after nerve-sparing radical prostatectomy. J Natl Cancer Inst 1989;16:1117–23.Article
- 3.Ficarra V, Novara G, Ahlering TE, Costello A, Eastham JA, Graefen M, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol 2012;62:418–30.ArticlePubMed
- 4.Wahle S, Reznicek M, Fallon B, Platz C, Williams R. Incidence of surgical margin involvement in various forms of radical prostatectomy. Urology 1990;36:23–6.ArticlePubMed
- 5.Vaidya A, Hawke C, Tiguert R, Civantos F, Soloway M. Intraoperative T staging in radical retropubic prostatectomy: is it reliable? Urology 2001;57:949–54.ArticlePubMed
- 6.Bonney WW, Fallon B, Gerber WL, Hawtrey CE, Loening SA, Narayana AS, et al. Cryosurgery in prostatic cancer survival. Urology 1982;14:37–42.Article
- 7.Onik GM, Cohen K, Reyes GD, Rubinsky B, Chang Z: Baust J. Transrectal ultrasound-guided percutaneous radical cryosurgical ablation of the prostate. Cancer 1993;72:1291–9.ArticlePubMed
- 8.Wong WS, Chinn DO, Chinn M, Chinn J, Tom WL, Tom WL. Cryosurgery as a treatment for prostate carcinoma: results and complications. Cancer 1997;79:963–74.ArticlePubMed
- 9.Robinson JW, Donnelly BJ, Saliken JC, Weber BA, Ernst S, Rewcastle JC. Quality of life and sexuality of men with prostate cancer 3 years after cryosurgery. Urology 2002;60:12–8.Article
- 10.Onik G, Narayan P, Vaughan D, Dineen M, Brunelle D. Focal “nerve-sparing” cryosurgery for treatment of primary prostate cancer: a new approach to preserving potency. Urology 2002;60:109–14.Article
- 11.Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Concensus Conference. Int J Radiat Oncol Biol Phys 2006;65:965–74.PubMed
- 12.Villers A, McNeal JE, Freiha FS, Stamey TA. Multiple cancers in the prostate: morphologic features of clinically recognized vs. incidental tumors. Cancer 1992;70:2312–38.
- 13.Cookson MS. Update on transrectal ultrasound guided needle biopsy of the prostate. Mol Urol 2000;4:93–7.PubMed
- 14.Sanchez-Ortiz RF, Broderick GA, Rovner ES, Wein AJ, Whittington R. Malkowicz SB. Erectile function and quality of life after interstitial radiation therapy for prostate cancer. Int J Impot Res 2000;12:SI8–24.Article
- 15.Zelefsky MJ, Hollister T, Raben A, Matthews S, Wallner KE. Five year biochemical outcome and toxicity with transperineal CT-planned permanent 1-125 prostate implantation for patients with localized prostate cancer. Int J Radiat Oncol Biol Phys 2000;47:1261–6.PubMed
- 16.O'Sullivan DC, Barrett DM, Colby TV, Lieber MM, Cupps RE. Effect of external beam radiation therapy on prostatic carcinoma DNA content as measured by static image cytometry. Eur Urol 1992;21:235–59.ArticlePubMed
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