PURPOSE: Patients currently diagnosed with low-risk prostate cancer are often over-treated and suffer from complications resulting in detriment to quality-of-life (QOL).
Targeted focal therapy (TFT) is a minimally invasive procedure designed to ablate tumor foci while minimizing collateral damage in order to maintain QOL.
MATERIALS AND METHODS: This is an IRB-approved prospective study conducted to assess the safety and efficacy of TFT using cryotherapy for men aged 40-85 years who were diagnosed with low-risk organ-confined prostate cancer (Gleason ≤ 7 (3+4) on TRUS biopsy, ≤ 50% tumor burden, and PSA < 10 ng/dL) at the University of Colorado between 2006 and 2009. Patients were evaluated for eligibility after undergoing three-dimensional mapping biopsy. Median duration of follow-up was 28 months (IQR: 26 to 31 months).
RESULTS: Sixty-two men with low-risk disease met the inclusion criteria. Biopsy at one year was negative in 50/62 (81%) patients. Of the 12 men who tested positive on repeat biopsy, all had a Gleason score of 3+3=6 with either one or two positive cores. The median PSA change was a decrease of 3.0 ng/dL (p < 0.01). The median AUA-SS change was a decrease of 1.5 points (p < 0.01). No significant change was observed in the SHIM score (p = 0.6). No episodes of urinary incontinence or severe side effects were observed.
CONCLUSIONS: TFT in carefully selected patients provides a feasible and practical option for the treatment of low-risk prostate cancer with minimal impact on QOL.
Written by:
Barqawi AB, Stoimenova D, Krughoff K, Eid K, O'Donnell C, Phillips JM, Crawford ED. Are you the author?
University of Colorado Denver School of Medicine, Department of Surgery, Division of Urology.
Reference: J Urol. 2014 Mar 15. pii: S0022-5347(14)02950-4.
doi: 10.1016/j.juro.2014.03.033
PubMed Abstract
PMID: 24641910
UroToday.com Prostate Cancer Section
