1,720,981 research outputs found
Cryoablation of the prostate for adenocarcinoma: a personal overview
No full textThe limitations of prostate cancer staging may be the reason for the use of neoplasms cryoablation therapy, at least in cases with a high risk of local spread. The theoretical basis of this concept was investigated, including the physiopathology of cryosurgical damage, cryosurgical and control insruments currently available, and necessity of team work of radiologists, pathologists and urologists. Although this approach appears to be supported by initial data, long-term follow-up is needed
Salvage cryosurgery for recurrent prostate carcinoma after radiotherapy
No full textCryotherapy is a salvage treatment for patients with biopsy-proved prostatic adenocarcinoma recurrent after radiotherapy. Proper sampling, labeling, and analysis of prostate biopsies allows prompt diagnosis, identification of important prognostic parameters, and planning of an appropriate therapeutic strategy. Whereas androgen-suppressive therapy is associated with only a temporary benefit, transperineal salvage cryosurgery offers a potentially curative option for patients with localized disease, even those with significant comorbidities. Technological advances, including computerized treatment planning and miniaturized cryoprobes, may provide further therapeutic advantages and lower complication rates. Cryotherapy should be included among the established therapeutic options for recurrence after radiotherap
Retrograde prostate colonization by metastatic gastric cancer following cryoablation for pT3 prostatic carcinoma
No full textProstatic gland cryoablation (PGC) is a recently developed procedure for treatment of localized prostatic cancer. We report an unusual case of cancer regression following PGC, with retrograde colonization by a diffusely metastazing gastric adenocarcinoma. Thi case confirms that PGC is an important tool in the management of prostatic tumor and that it may be also considered in the tratment of locally invasive (pT3, C) disease
Histopathological comparison of prostatic glands pre/post-cryoablation therapy (CAT) for carcinoma
No full textCryoablation therapy (CAT) has been recently introduced as an alternative means to treat prostatic cancer. Claimed advantages includes effectiveness in treating also locally advanced cancers and the low morbidity expecially if compared to the traditiona treatments, i.e. prostatectomy and/or radiation therapy. We report results observed in 23 patients with prostatic cancer treated with CAT. The results indicate that cryosurgery has a locally significant effect in destroying prostatic cancer not only in low stage, but even in a certain number of cases with locally advanced disease
Ultrasound-guided cryosurgery of the prostate: short- and long-term experience
No full textWe have assessed 24 patients consecutively treated with cryosurgery and chosen according to the guidelines of the European Study Group of Urologic Cryosurgeons. Of the 24 patients (average age about 70, range 61-79), all were not considered candidates for radical prostatectomy, 9 (37%) were clinical stage cT2 N0M0, 15 (63%) cT3 N0M0 who had not received any prior treatment, except 1 patient (61 years old) who was treated with TCT and successive recurrence of the disease (cT2). Of the 24 chosen patients, 13 (55%) were over the age of 71, 11 (45%) had important factors of co-morbidity and an elevated risk of surgery (ASA 3). The average PSA was of 19.3 ng/ml (range 2.2-61). Gleason score was 2-5 in 9 cases, 6-7 in 14 and 8-10 in 1 case. In the follow-up, we evaluated serum PSA every 3 months and transrectal ultrasound and the echoguided prostatic biopsies at 6, 12 and 24 months. Post-operative complications included: ecchymosis and edema of external genitals (16/24), fever > 38 degrees C (1/24), sloughing syndrome (6/24), urinary tract infections (10/24) acute urine retention (1/24). In 2 cases, 6 months after treatment, a transrectal resection was carried out. After a follow-up at 6 months, the PSA was 0.4 ng/ml (range 0.1-0.9), in 1 case. In positive core biopsy out of 6 showed neoplastic cells with fibrous tissue; the patient had a PSA of 0.58 ng/ml. At 12 months there were 11 assessable patients. The average PSA was 0.3 ng/ml (range 0.1-0.9). At 24 months there were 4 assessable patients, 1 of 4 showed serum PSA level of 4 ng/ml and cancer in apical biopsy. Erectile dysfunction was assessed on 8 patients affective before surgery: 1 referred to sufficient erections at penetration (1/8, 12.5%). After removal of the catheter, 4 of the 20 patients suffered stress and urge incontinence with the use of 1 pad a day. In 1 case, 18 months from surgery, slight stress incontinence was found (1 pad/day). Cryoablation is an efficient method and is given to slight post-operative morbidity and no intra-operative mortality, also in patients with high risk for open surgery. Indications may be found in patients with the following conditions: older than 72 years, severe co-morbidity and high risk for surgery, neoplasia at high risk of progression, and disease recurrence after radiotherapy. Our case history is at the moment encouraging and a larger number of cases as well as longer follow-up are needed
La tecnica di Onik nella criochirurgia percutanea della prostata: vantaggi e fattibilità
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