The Feasibility and Safety of Repeat Cryosurgical Ablation of Localized Prostate Cancer

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Journal Title, Volume, Page: 
World Journal of Surgical Oncology201513:340 DOI: 10.1186/s12957-015-0753-9
Year of Publication: 
Mahmoud Mustafa
Urology Department, Faculty of Medicine and Health Science, An-Najah National University, An-Najah University Hospital
Current Affiliation: 
Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus. Palestine
Scott Delacroix
John F Ward
Louis Pisters
Preferred Abstract (Original): 
The aim of the study was to assess the morbidity and efficacy of repeat cryoablation (CA) in the treatment of localized prostate cancer.
Twenty-seven patients with median age of 71 years (range 48–80) who underwent repeat CA between April 2003 and April 2011 at a single institution were included. The median initial prostate-specific antigens (PSA) and Gleason values were 6.2 ng/ml (range 4–23.6) and 7 (range 6–9), respectively. Twenty-four patients underwent two CA treatments, and three patients underwent three CA treatments. Pre- and perioperative parameters and oncological and functional outcomes were evaluated.
No intraoperative complications occurred. After the first CA, PSA was undetectable in 10 patients, and the median nadir PSA value was 0.65 ng/ml (range 0.1–4.9). After the second CA, 4 patients had undetectable PSA, and the median nadir PSA value was 1.25 ng/ml (range 0.2–7.9). For patients who underwent a third CA treatment, no patients had undetectable PSA, and the subsequent median nadir PSA value was 1.6 ng/ml (range 0.4–4.5). Two patients had incontinence (1 pad per day) following repeat CA. One patient had urinary retention after the third CA treatment, and one had urethral stricture. The mean hospitalization and follow-up periods were 1 day (range 0–2) and 51.5 months (range 11–96), respectively.
Repeat CA successfully reduced PSA levels, and complications were modest. We conclude that repeat CA is a feasible, safe, and effective treatment option for localized prostate cancer.
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