Percutaneous cryoablation of the prostate: preliminary results after 95 procedures.

Abstract

We examined the role of percutaneous cryoablation of the prostate in the treatment of prostate cancer. We performed 95 percutaneous cryoablations of the prostate on 87 patients with prostate cancer. Of the patients 6 had positive lymph nodes preoperatively, radiation failed in 9 and 9 began postoperative hormonal therapy because of treatment failure. Mean patient age, prostate specific antigen (PSA) level (ng./ml.) and Gleason score were 65.4, 12.60 and 6.03, respectively. Median followup was 12 months (mean 9.3, range 1 to 24). In 49 of the 87 patients (56%) the lymph nodes were evaluated before cryoablation based on the treatment protocol. Median PSA level at 12 months was 0.55 ng./ml. (mean 1.73) with a 17% positive biopsy rate at 3 months. When the positive lymph node, radiation failure and postoperative hormonal therapy groups were removed from analysis, the median PSA level was 0.80 ng./ml. (mean 1.86) with a 5% positive biopsy rate. Of the patients in the radiation failure group 37% had a positive biopsy at 3 months. Cases were classified according to stage, grade and PSA level, and the biopsy results were presented. The complications of percutaneous cryoablation of the prostate were reviewed. The low percentage of positive biopsies is encouraging but the significance of the persistent PSA levels remains uncertain.