Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation
Purpose To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment. Methods Data from 110 consecutive patients treated with PGC for localized PCa were collected. All patients underwent the...
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| Veröffentlicht in: | International urology and nephrology 2023-05, Vol.55 (5), p.1125-1132 |
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| creator | Selvaggio, Oscar Finati, Marco Falagario, Ugo Giovanni Silecchia, Giovanni Recchia, Marco Checchia, Andrea Alberto Milillo, Paola Sanguedolce, Francesca Cindolo, Luca Busetto, Gian Maria Bettocchi, Carlo Cormio, Luigi Carrieri, Giuseppe |
| description | Purpose
To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment.
Methods
Data from 110 consecutive patients treated with PGC for localized PCa were collected. All patients underwent the same standardized follow-up with serum-PSA level and digital rectal examination. Prostate MRI and eventual re-biopsy were performed at twelve months after cryotherapy or in case of suspicion of recurrence. Biochemical recurrence was defined according to Phoenix criteria (PSA nadir + 2 ng/ml). Kaplan–Meier curves and Multivariable Cox Regression analyses were used to predict disease progression, biochemical recurrence- (BCS) and additional treatment-free survival (TFS).
Results
Median age was 75 years (IQR 70–79). PGC was performed in 54 (49.1%) patients with low-risk PCa, 42 (38.1%) with intermediate risk and 14 (12.8%) high risk. At a median follow-up of 36 months, we recorded a BCS and TFS of 75 and 81%, respectively. At 5 years, BCS was 68.5% and CRS 71.5%.
High-risk prostate cancer was associated with lower TFS and BCS curves when compared with low-risk group (all
p
values |
| doi_str_mv | 10.1007/s11255-023-03519-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10105669</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2778978046</sourcerecordid><originalsourceid>FETCH-LOGICAL-c475t-5a2d97e8a7e5df3b79b7e6f636c3cfb7ea2c60f817dffd105ffc2e13a4011af63</originalsourceid><addsrcrecordid>eNp9kUFv1DAQhS0EoqXwBzggS1y4BMZ2HCdcEKooIFXiUm5I1qwzblN542B7kcKvx9stpXDg5JHme29m_Bh7LuC1ADBvshBS6wakakBpMTTrA3YstFGN1H378F59xJ7kfA0AQw_wmB2proeha-Ux-3aRCMuW5sKj5yE6DNNPGvmSYi5YiDucHSU-zZzCSCmsfMEyVT6_5eWKeIqB9tIFU5kwcJfWiJtQmTg_ZY88hkzPbt8T9vXsw8Xpp-b8y8fPp-_PG9caXRqNchwM9WhIj15tzLAx1PlOdU45X2uUrgPfCzN6PwrQ3jtJQmELQmDlTti7g--y22xpdHW7hMEuadpiWm3Eyf7dmacrexl_WAHVreuG6vDq1iHF7zvKxW6n7CgEnCnuspXG9IPpod0Pe_kPeh13aa73WdmDaKFV0lRKHihXPzIn8nfbCLD79OwhPVvTszfp2bWKXty_407yO64KqAOQa2u-pPRn9n9sfwGhwah7</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2801404327</pqid></control><display><type>article</type><title>Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Selvaggio, Oscar ; Finati, Marco ; Falagario, Ugo Giovanni ; Silecchia, Giovanni ; Recchia, Marco ; Checchia, Andrea Alberto ; Milillo, Paola ; Sanguedolce, Francesca ; Cindolo, Luca ; Busetto, Gian Maria ; Bettocchi, Carlo ; Cormio, Luigi ; Carrieri, Giuseppe</creator><creatorcontrib>Selvaggio, Oscar ; Finati, Marco ; Falagario, Ugo Giovanni ; Silecchia, Giovanni ; Recchia, Marco ; Checchia, Andrea Alberto ; Milillo, Paola ; Sanguedolce, Francesca ; Cindolo, Luca ; Busetto, Gian Maria ; Bettocchi, Carlo ; Cormio, Luigi ; Carrieri, Giuseppe</creatorcontrib><description>Purpose
To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment.
Methods
Data from 110 consecutive patients treated with PGC for localized PCa were collected. All patients underwent the same standardized follow-up with serum-PSA level and digital rectal examination. Prostate MRI and eventual re-biopsy were performed at twelve months after cryotherapy or in case of suspicion of recurrence. Biochemical recurrence was defined according to Phoenix criteria (PSA nadir + 2 ng/ml). Kaplan–Meier curves and Multivariable Cox Regression analyses were used to predict disease progression, biochemical recurrence- (BCS) and additional treatment-free survival (TFS).
Results
Median age was 75 years (IQR 70–79). PGC was performed in 54 (49.1%) patients with low-risk PCa, 42 (38.1%) with intermediate risk and 14 (12.8%) high risk. At a median follow-up of 36 months, we recorded a BCS and TFS of 75 and 81%, respectively. At 5 years, BCS was 68.5% and CRS 71.5%.
High-risk prostate cancer was associated with lower TFS and BCS curves when compared with low-risk group (all
p
values < .03). A PSA reduction < 50% between preoperative level and nadir resulted as an independent failure predictor for all outcomes evaluated (all
p
values < .01). Age was not associated with worse outcomes.
Conclusions
PGC could be a valid treatment for low- to intermediate PCa in elderly patients, when a curative approach is suitable in terms of life expectancy and quality of life.</description><identifier>ISSN: 1573-2584</identifier><identifier>ISSN: 0301-1623</identifier><identifier>EISSN: 1573-2584</identifier><identifier>DOI: 10.1007/s11255-023-03519-y</identifier><identifier>PMID: 36809642</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Aged ; Biopsy ; Cryosurgery - methods ; Cryotherapy ; Humans ; Life span ; Male ; Medicine ; Medicine & Public Health ; Neoplasm Recurrence, Local - etiology ; Nephrology ; Prostate cancer ; Prostate-Specific Antigen ; Prostatic Neoplasms - pathology ; Quality of Life ; Risk groups ; Treatment Outcome ; Urology ; Urology - Original Paper</subject><ispartof>International urology and nephrology, 2023-05, Vol.55 (5), p.1125-1132</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c475t-5a2d97e8a7e5df3b79b7e6f636c3cfb7ea2c60f817dffd105ffc2e13a4011af63</citedby><cites>FETCH-LOGICAL-c475t-5a2d97e8a7e5df3b79b7e6f636c3cfb7ea2c60f817dffd105ffc2e13a4011af63</cites><orcidid>0000-0002-7425-1166</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11255-023-03519-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11255-023-03519-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36809642$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Selvaggio, Oscar</creatorcontrib><creatorcontrib>Finati, Marco</creatorcontrib><creatorcontrib>Falagario, Ugo Giovanni</creatorcontrib><creatorcontrib>Silecchia, Giovanni</creatorcontrib><creatorcontrib>Recchia, Marco</creatorcontrib><creatorcontrib>Checchia, Andrea Alberto</creatorcontrib><creatorcontrib>Milillo, Paola</creatorcontrib><creatorcontrib>Sanguedolce, Francesca</creatorcontrib><creatorcontrib>Cindolo, Luca</creatorcontrib><creatorcontrib>Busetto, Gian Maria</creatorcontrib><creatorcontrib>Bettocchi, Carlo</creatorcontrib><creatorcontrib>Cormio, Luigi</creatorcontrib><creatorcontrib>Carrieri, Giuseppe</creatorcontrib><title>Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation</title><title>International urology and nephrology</title><addtitle>Int Urol Nephrol</addtitle><addtitle>Int Urol Nephrol</addtitle><description>Purpose
To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment.
Methods
Data from 110 consecutive patients treated with PGC for localized PCa were collected. All patients underwent the same standardized follow-up with serum-PSA level and digital rectal examination. Prostate MRI and eventual re-biopsy were performed at twelve months after cryotherapy or in case of suspicion of recurrence. Biochemical recurrence was defined according to Phoenix criteria (PSA nadir + 2 ng/ml). Kaplan–Meier curves and Multivariable Cox Regression analyses were used to predict disease progression, biochemical recurrence- (BCS) and additional treatment-free survival (TFS).
Results
Median age was 75 years (IQR 70–79). PGC was performed in 54 (49.1%) patients with low-risk PCa, 42 (38.1%) with intermediate risk and 14 (12.8%) high risk. At a median follow-up of 36 months, we recorded a BCS and TFS of 75 and 81%, respectively. At 5 years, BCS was 68.5% and CRS 71.5%.
High-risk prostate cancer was associated with lower TFS and BCS curves when compared with low-risk group (all
p
values < .03). A PSA reduction < 50% between preoperative level and nadir resulted as an independent failure predictor for all outcomes evaluated (all
p
values < .01). Age was not associated with worse outcomes.
Conclusions
PGC could be a valid treatment for low- to intermediate PCa in elderly patients, when a curative approach is suitable in terms of life expectancy and quality of life.</description><subject>Aged</subject><subject>Biopsy</subject><subject>Cryosurgery - methods</subject><subject>Cryotherapy</subject><subject>Humans</subject><subject>Life span</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Recurrence, Local - etiology</subject><subject>Nephrology</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Quality of Life</subject><subject>Risk groups</subject><subject>Treatment Outcome</subject><subject>Urology</subject><subject>Urology - Original Paper</subject><issn>1573-2584</issn><issn>0301-1623</issn><issn>1573-2584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp9kUFv1DAQhS0EoqXwBzggS1y4BMZ2HCdcEKooIFXiUm5I1qwzblN542B7kcKvx9stpXDg5JHme29m_Bh7LuC1ADBvshBS6wakakBpMTTrA3YstFGN1H378F59xJ7kfA0AQw_wmB2proeha-Ux-3aRCMuW5sKj5yE6DNNPGvmSYi5YiDucHSU-zZzCSCmsfMEyVT6_5eWKeIqB9tIFU5kwcJfWiJtQmTg_ZY88hkzPbt8T9vXsw8Xpp-b8y8fPp-_PG9caXRqNchwM9WhIj15tzLAx1PlOdU45X2uUrgPfCzN6PwrQ3jtJQmELQmDlTti7g--y22xpdHW7hMEuadpiWm3Eyf7dmacrexl_WAHVreuG6vDq1iHF7zvKxW6n7CgEnCnuspXG9IPpod0Pe_kPeh13aa73WdmDaKFV0lRKHihXPzIn8nfbCLD79OwhPVvTszfp2bWKXty_407yO64KqAOQa2u-pPRn9n9sfwGhwah7</recordid><startdate>20230501</startdate><enddate>20230501</enddate><creator>Selvaggio, Oscar</creator><creator>Finati, Marco</creator><creator>Falagario, Ugo Giovanni</creator><creator>Silecchia, Giovanni</creator><creator>Recchia, Marco</creator><creator>Checchia, Andrea Alberto</creator><creator>Milillo, Paola</creator><creator>Sanguedolce, Francesca</creator><creator>Cindolo, Luca</creator><creator>Busetto, Gian Maria</creator><creator>Bettocchi, Carlo</creator><creator>Cormio, Luigi</creator><creator>Carrieri, Giuseppe</creator><general>Springer Netherlands</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7425-1166</orcidid></search><sort><creationdate>20230501</creationdate><title>Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation</title><author>Selvaggio, Oscar ; Finati, Marco ; Falagario, Ugo Giovanni ; Silecchia, Giovanni ; Recchia, Marco ; Checchia, Andrea Alberto ; Milillo, Paola ; Sanguedolce, Francesca ; Cindolo, Luca ; Busetto, Gian Maria ; Bettocchi, Carlo ; Cormio, Luigi ; Carrieri, Giuseppe</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c475t-5a2d97e8a7e5df3b79b7e6f636c3cfb7ea2c60f817dffd105ffc2e13a4011af63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Aged</topic><topic>Biopsy</topic><topic>Cryosurgery - methods</topic><topic>Cryotherapy</topic><topic>Humans</topic><topic>Life span</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Recurrence, Local - etiology</topic><topic>Nephrology</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Quality of Life</topic><topic>Risk groups</topic><topic>Treatment Outcome</topic><topic>Urology</topic><topic>Urology - Original Paper</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Selvaggio, Oscar</creatorcontrib><creatorcontrib>Finati, Marco</creatorcontrib><creatorcontrib>Falagario, Ugo Giovanni</creatorcontrib><creatorcontrib>Silecchia, Giovanni</creatorcontrib><creatorcontrib>Recchia, Marco</creatorcontrib><creatorcontrib>Checchia, Andrea Alberto</creatorcontrib><creatorcontrib>Milillo, Paola</creatorcontrib><creatorcontrib>Sanguedolce, Francesca</creatorcontrib><creatorcontrib>Cindolo, Luca</creatorcontrib><creatorcontrib>Busetto, Gian Maria</creatorcontrib><creatorcontrib>Bettocchi, Carlo</creatorcontrib><creatorcontrib>Cormio, Luigi</creatorcontrib><creatorcontrib>Carrieri, Giuseppe</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International urology and nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Selvaggio, Oscar</au><au>Finati, Marco</au><au>Falagario, Ugo Giovanni</au><au>Silecchia, Giovanni</au><au>Recchia, Marco</au><au>Checchia, Andrea Alberto</au><au>Milillo, Paola</au><au>Sanguedolce, Francesca</au><au>Cindolo, Luca</au><au>Busetto, Gian Maria</au><au>Bettocchi, Carlo</au><au>Cormio, Luigi</au><au>Carrieri, Giuseppe</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation</atitle><jtitle>International urology and nephrology</jtitle><stitle>Int Urol Nephrol</stitle><addtitle>Int Urol Nephrol</addtitle><date>2023-05-01</date><risdate>2023</risdate><volume>55</volume><issue>5</issue><spage>1125</spage><epage>1132</epage><pages>1125-1132</pages><issn>1573-2584</issn><issn>0301-1623</issn><eissn>1573-2584</eissn><abstract>Purpose
To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment.
Methods
Data from 110 consecutive patients treated with PGC for localized PCa were collected. All patients underwent the same standardized follow-up with serum-PSA level and digital rectal examination. Prostate MRI and eventual re-biopsy were performed at twelve months after cryotherapy or in case of suspicion of recurrence. Biochemical recurrence was defined according to Phoenix criteria (PSA nadir + 2 ng/ml). Kaplan–Meier curves and Multivariable Cox Regression analyses were used to predict disease progression, biochemical recurrence- (BCS) and additional treatment-free survival (TFS).
Results
Median age was 75 years (IQR 70–79). PGC was performed in 54 (49.1%) patients with low-risk PCa, 42 (38.1%) with intermediate risk and 14 (12.8%) high risk. At a median follow-up of 36 months, we recorded a BCS and TFS of 75 and 81%, respectively. At 5 years, BCS was 68.5% and CRS 71.5%.
High-risk prostate cancer was associated with lower TFS and BCS curves when compared with low-risk group (all
p
values < .03). A PSA reduction < 50% between preoperative level and nadir resulted as an independent failure predictor for all outcomes evaluated (all
p
values < .01). Age was not associated with worse outcomes.
Conclusions
PGC could be a valid treatment for low- to intermediate PCa in elderly patients, when a curative approach is suitable in terms of life expectancy and quality of life.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>36809642</pmid><doi>10.1007/s11255-023-03519-y</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-7425-1166</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | International urology and nephrology, 2023-05, Vol.55 (5), p.1125-1132 |
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| language | eng |
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| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Aged Biopsy Cryosurgery - methods Cryotherapy Humans Life span Male Medicine Medicine & Public Health Neoplasm Recurrence, Local - etiology Nephrology Prostate cancer Prostate-Specific Antigen Prostatic Neoplasms - pathology Quality of Life Risk groups Treatment Outcome Urology Urology - Original Paper |
| title | Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation |
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