Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients.

Détails

ID Serval
serval:BIB_D9155F1E5BD9
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients.
Périodique
The British journal of radiology
Auteur(s)
De Marini P., Cazzato R.L., Garnon J., Tricard T., Koch G., Tsoumakidou G., Ramamurthy N., Lang H., Gangi A.
ISSN
1748-880X (Electronic)
ISSN-L
0007-1285
Statut éditorial
Publié
Date de publication
05/2019
Peer-reviewed
Oui
Volume
92
Numéro
1097
Pages
20180965
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
To assess the safety and oncological efficacy of percutaneous MR-guided whole-gland prostate cancer (PCa) cryoablation (CA).
Between July 2009 and January 2018, 30 patients (mean age 72.9 ± 5.13 years) with histologically proven, organ-confined (≤ T2cN0M0), predominantly low/intermediate-risk PCa (median Gleason score 7; mean prostate specific antigen 6.05 ± 3.74 ng ml <sup>-1</sup> ) underwent MR-guided whole-gland CA. Patients were selected on the basis of prior pelvic radiotherapy (n = 16; 12 for previous PCa), or contra indication/refusal of surgery or radiotherapy. Complications, local progression-free survival (LPFS) and overall survival (OS) were retrospectively investigated.
Eighteen [60%] patients reported procedure-related complications: 5/18 [28%] needed surgical/interventional treatments and 13 [72%] conservative or pharmacological treatment. Eleven [73%] complications were noted in the first 15 patients and 7 [47%] in the last 15 patients (p = 0.26). Mean nadir prostate specific antigen was 0.24 ± 1.5 ng ml <sup>-1</sup> (mean follow-up 3.8 years; range: 2 - 2915 days). Seven [23%] patients developed histologically proven local progression (mean time to recurrence 775 days, range: 172 - 2014). Mean clinical follow-up was 3.8 years (range 1-2915 days). LPFS was 92.0, 75.7 and 69.4 % at 1-, 3- and 5 year follow-up, respectively. For patients in salvage treatment, LPFS was 100%, 75%, and 75% at 1-, 3- and 5 year follow-up. OS was 100%, 94.4 and 88.5 % at 1-, 3- and 5 year follow-up respectively, with no patients dying from PCa.
Whole-gland PCa CA offers good oncological efficacy, particularly in post-radiotherapy cases. Although the complication rate is significant, the majority is minor and is managed with conservative or pharmacologic management.
MRI-guided whole-gland prostate cancer cryoablation offers good oncological efficacy, particularly in post-radiotherapy cases with a contained complication rate.
Mots-clé
Aged, Aged, 80 and over, Cryosurgery/adverse effects, Cryosurgery/methods, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Neoplasm Grading, Progression-Free Survival, Prostate-Specific Antigen/blood, Prostatic Neoplasms/pathology, Prostatic Neoplasms/radiotherapy, Prostatic Neoplasms/surgery, Retrospective Studies, Risk Assessment, Salvage Therapy, Survival Analysis, Treatment Outcome
Pubmed
Web of science
Création de la notice
08/04/2019 18:15
Dernière modification de la notice
20/08/2019 16:58
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