SHOULD CRYOSURGERY BE CONSIDERED A THERAPEUTIC OPTION IN LOCALIZED PROSTATE CANCER? - 11/09/11

Doi : 10.1016/S0094-0143(05)70341-4

John A. Connolly, MB, FRCSI ^{^{*
From the Department of Urology and The Program in Urologic Oncology, University of California San Francisco/Mt. Zion Cancer Center, University of California San Francisco School of Medicine, and San Francisco Veterans Administration Medical Center, San Francisco, California}}, Katsuto Shinohara, MD ^{^{*
From the Department of Urology and The Program in Urologic Oncology, University of California San Francisco/Mt. Zion Cancer Center, University of California San Francisco School of Medicine, and San Francisco Veterans Administration Medical Center, San Francisco, California}}, Joseph C. Presti, MD ^{^{*
From the Department of Urology and The Program in Urologic Oncology, University of California San Francisco/Mt. Zion Cancer Center, University of California San Francisco School of Medicine, and San Francisco Veterans Administration Medical Center, San Francisco, California}}, Peter R. Carroll, MD ^{^{*
From the Department of Urology and The Program in Urologic Oncology, University of California San Francisco/Mt. Zion Cancer Center, University of California San Francisco School of Medicine, and San Francisco Veterans Administration Medical Center, San Francisco, California}}

Resumen

In 1995, prostate cancer claimed approximately 40,000 lives in the United States and an additional 240,000 men were diagnosed with this condition.^{21 Wingo P.A., Tong T., Bolden S. Cancer statistics, 1995 CA Cancer J Clin 1995 ; 45 : 8 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} The optimal treatment for prostate cancer is a matter of much debate. Although there is no absolute consensus, most urologists agree that the treatment of choice for organ-confined prostate cancer (T1 and T2 tumors) occurring in young, healthy men, is radical prostatectomy. When carried out for the appropriate indication, radical surgery is associated with minimal mortality and acceptably low morbidity rates.^{11 Murphy G.P., Mettlin C., Menck H. , y al. National patterns of prostate cancer treatment by radical prostatectomy: Results of a survey by the American College of Surgeons Commission on Cancer J Urol 1994 ; 152 : 1817

Haga clic aquí para ir a la sección de Referencias, 19 Walsh P.C., Partin A.W., Epstein J.I. Cancer control and quality of life following anatomical radical retropubic prostatectomy: Results at 10 years J Urol 1994 ; 152 : 1831

Haga clic aquí para ir a la sección de Referencias, 24 Zincke H., Oesterling J.E., Blute M.L. , y al. Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer J Urol 1994 ; 152 : 1850

Haga clic aquí para ir a la sección de Referencias} Reported cure rates with surgery vary but approach 80% for low-volume disease (T1 to T2, PSA <10 ng/mL).

Cryosurgery as a treatment for localized prostate cancer has seen renewed interest in recent years because of promising initial reports citing low morbidity, minimal blood loss, short hospital stay, and high rates of negative posttreatment biopsy results.^{1 Bahn D.K., Lee F., Solomon M.H. , y al. Prostate cancer: US-guided percutaneous cryoablation Radiology 1995 ; 194 : 551

Haga clic aquí para ir a la sección de Referencias, 16 Onik G.M., Cohen J.K., Reyes G.D. , y al. Transrectal ultrasound-guided percutaneous radical cryosurgical ablation of the prostate CA Cancer J Clin 1993 ; 72 : 1291 [cross-ref]

Haga clic aquí para ir a la sección de Referencias} Use of transrectal ultrasound (TRUS) for real-time monitoring of the freezing process, improved cryoprobes, and better understanding of cryobiology have all contributed to this resurgence of interest in cryosurgical therapy.^{3 Chang Z., Finkelstein J.J., Ma H., Baust J. Development of a high-performance multiprobe cryosurgical device Biomed Instrum Technol 1994 ; 28 : 383

Haga clic aquí para ir a la sección de Referencias, 9 Littrup P.J., Montie J., Mody A. , y al. Prostatic cryotherapy: Ultrasonographic and pathological correlation in the canine model Urology 1994 ; 44 : 175 [cross-ref]

Haga clic aquí para ir a la sección de Referencias, 15 Onik G., Cobb C., Cohen J. , y al. US characteristics of frozen prostate Radiology 1988 ; 168 : 629

Haga clic aquí para ir a la sección de Referencias} These advances have allowed more efficient freezing of the prostate gland while reducing damage to surrounding tissues, notably the rectum and urethral sphincter. In addition to treating organ-confined tumors, cryotherapy has been proposed as a possible low-morbidity treatment for patients with T3 disease or for patients with residual or recurrent cancer following radiation therapy.

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Esquema

HISTORY OF CRYOSURGERY

CRYOSURGICAL TECHNIQUE

PATIENT SELECTION AND EVALUATION

CRYOSURGICAL RESULTS

DISCUSSION

CONCLUSIONS

Address reprint requests to Peter R. Carroll, MD, Department of Urology, U-575, University of California, San Francisco, CA 94143–0738

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Vol 23 - N° 4

P. 623-631 - novembre 1996 Regresar al número

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