Cryoablation



Fig. 25.1
Changes in total number of focal and whole gland prostate cryoablation procedures per year



A214191_1_En_25_Fig2_HTML.gif


Fig. 25.2
Variation over time in risk group categorization at time of prostate cryoablation



Table 25.1
Clinical characteristics of men within the COLD Registry undergoing organ preserving, whole gland and salvage prostate cryoablation during the same study time period.




































































































































































 
Organ preserving cryoablation
Whole gland cryoablation
Salvage cryoablation

Number of Patients

1160

4099

594

Mean Age (S.D.) years
67.8 (7.80)
  
70.4 (21.8)
  
70.2 (6.8)
  

Mean Follow-up (S.D.) months
21.1 (19.7)
  
31.8 (30.5)
  
38.5 (39.5)
  

Gleason Sum (available n)
1148
99%
3982
97%
564
95%

≤ 6
844
74%
2383
60%
249
44%

7
240
21%
1046
26%
168
30%

≥8
64
6%
553
14%
147
26%

Clinical stage (available n)
1160
100%
4099
100%
594
100%

<T2b
1013
87%
2863
70%
458
77%

≥T2b
147
13%
1236
30%
136
23%

PSA (ng/ml) at baseline (available n)
1149
99%
4011
98%
590
99%

< 4
211
18%
618
15%
187
32%

4<10
782
68%
2374
59%
254
43%

10<20
126
11%
707
18%
94
16%

20 +
30
3%
312
8%
55
9%

Risk category* (available n)
1157
100%
4067
99%
592
100%

Low-risk
541
47%
934
23%
57
10%

Intermediate-risk
473
41%
1885
46%
294
50%

High-risk
143
12%
1248
31%
241
41%


* Patients risk is assigned to one of 3 categories using D’Amico risk definitions.

Low risk: Gleason score ≤6 AND ≤ clinical stage T2a AND PSA <10 ng/ml.

High risk: Gleason score 8 or higher and/or PSA >20 ng/ml and/or >T2b.

Intermediate Risk anything else.



Table 25.2
Freedom from biochemical recurrence of prostate cancer following organ preserving cryoablations compared with matched patients undergoing whole gland cryoablation during the same study time period.





























Time from cryosurgery
Freedom from biochemical failure (ASTRO)

Organ preservation prostate cryoablation (%)
Whole gland prostate cryoablation (%)

6 months
84.2
83.3

12 months
80.7
78.7

24 months
75.7
75.5

36 months
75.7
75.1



Table 25.3
Comparison of biopsy results following organ preserving cryoablation and whole gland cryoablation.






















 
Organ preserving cryoablation (n=1160)
Whole Gland Cryoablation (n=4099)

Number of patients who underwent a biopsy after prostate cryoablation (%)
163 (14.1)
841 (20.6)

Positive biopsy of those who underwent biopsy (%)
43 (26.3)
125 (14.9)

Positive biopsy of entire cohort (%)
3.7
3.0



Table 25.4
Comparison of treatment associated morbidity at 12-months.























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Apr 11, 2016 | Posted by in GENERAL RADIOLOGY | Comments Off on Cryoablation

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Morbidity by procedure type

(n is number of patients in whom sufficient pre and post procedure information is available for analysis)
# of patients (%)

Urinary Incontinence
 

Organ preserving (507)
8 (1.6)

Whole gland (2099)
65 (3.1)

Salvage (299)
33 (12.3)

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