By David Douglas
NEW YORK (Reuters Health) - 31/1/2019
Focal cryotherapy for nonmetastatic clinically significant prostate cancer shows largely good outcomes at up to three years, according to UK researchers.
In a January 9 online paper in European Urology, Dr. Taimur T. Shah of Imperial College London, and colleagues note that the approach offers an alternative to radical prostatectomy or radiotherapy in patients with intermediate- and high-risk prostate cancer.
"Whilst these are good treatments," Dr. Shah told Reuters Health by email, "they confer significant side-effects in terms of erectile dysfunction and urinary leakage due to damage to surrounding structures such as the nerves, bladder and back passage."
However, in focal cryotherapy, "by freezing only the areas of cancer within the prostate leaving healthy prostate tissue behind ... this limits the degree of damage caused to the surrounding structures and gives us the ability to treat the cancer whilst preserving urinary and erectile function."
To examine its efficacy, the researchers studied registry data on 122 patients who underwent the procedure between 2013 and 2016. Median follow-up was for more than 27 months. A total of 35 patients were deemed at high risk and the remaining 87 at intermediate risk.
Overall failure-free survival at three years was 90.5%. This amounted to 84.7% of the high-risk group and 93.3% of the intermediate risk group. No incontinence requiring any pad use was reported at last follow-up.
Of the 31 patients who had preoperative erections sufficient for penetration, five (16.1%) were no longer potent. There were no rectal adverse events.
"In comparison," Dr. Shah continued, "the traditional treatments, surgery and radiotherapy, can lead to urinary leakage - needing to wear a daily pad - in 5% to 15% of men and erectile problems in over 50%."
Dr. Shah concluded, "Although long term data is needed on focal cryotherapy, in the early to medium term it appears to offer good control of the cancer whilst preserving a man's quality of life."
SOURCE: http://bit.ly/2TnCCNu Eur Urol 2019.
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