Department of Urology, Wayne State University, Detroit, MI, USA.
BJU Int. 2011 Aug;108(4):508-12. doi: 10.1111/j.1464-410X.2011.10238.x. Epub 2011 Jul 1.
Study Type - Therapy (outcomes research).
2c. What's known on the subject? and What does the study add? Most elderly patient with prostate cancer undergo radiation therapy, but cryoablation has gained popularity. This study demonstrates the safety and efficiency of this new approach.
• To report on the largest data set regarding outcomes for whole gland prostate cryoablation as a primary treatment of prostate cancer in older men, which we empirically defined as age >75 years.
• The COLD (Cryo On-Line Data) Registry consists of case report forms with pre- and post-treatment information obtained from patients undergoing prostate cryoablation. • A total of 860 patients were stratified into low-, intermediate- and high-risk groups (D'Amico 2003 risk definitions). • Biochemical disease-free survival (bDFS) was defined according to the traditional American Society for Therapeutic Radiology and Oncology definition (3 increases) and the newer (Phoenix) definition (nadir +2). • Biopsy was performed at physician discretion but most commonly for cause if a patient had an increasing or suspicious prostate-specific antigen level (PSA).
• The median age was 79 years (76-91) and the median follow-up was 16 months (4-60). • The 5-year [95% confidence interval (CI)] bDFS for the entire population using ASTRO and Phoenix definitions was 79% (4%) and 62.6% (8.3%), respectively. • Stratified by risk group, 5-year bDFS (ASTRO) was 82.4% (7.9%), 78.3% (5.8%) and 77.6% (7.7%) for low, moderate and high risk, respectively. • Using the Phoenix definition, 5-year bDFS was 74.9%± 15.3%, 61.4%± 13.2% and 58.0%± 11.9% for low-, moderate- and high-risk groups, respectively. • Incontinence was reported in eight patients (0.9%).
• Whole gland cryoablation in older men maintains oncological efficacy similar to that of younger men without increased morbidity.
研究类型 - 治疗（结局研究）。
2c。本领域已知的内容是什么？本研究增加了什么内容？大多数老年前列腺癌患者接受放射治疗，但冷冻消融术已越来越受欢迎。本研究证明了这种新方法的安全性和有效性。
•报告最大的一组关于全腺体前列腺冷冻消融术作为老年男性前列腺癌主要治疗方法的结果数据，我们根据经验将其定义为年龄>75 岁。
•COLD（冷冻在线数据）登记处包含从接受前列腺冷冻消融术的患者中获得的病例报告表，包含治疗前后的信息。•860 名患者分为低、中、高危组（2003 年 D'Amico 风险定义）。•生化无疾病生存（bDFS）根据传统的美国放射治疗肿瘤学会（ASTRO）定义（3 次升高）和较新的（凤凰城）定义（最低点+2）定义。•活检由医生酌情进行，但最常见的是如果患者的前列腺特异性抗原（PSA）水平升高或出现可疑情况。
•中位年龄为 79 岁（76-91 岁），中位随访时间为 16 个月（4-60 个月）。•使用 ASTRO 和凤凰城定义，整个人群的 5 年 bDFS（ASTRO）分别为 79%（4%）和 62.6%（8.3%）。•按风险组分层，5 年 bDFS（ASTRO）分别为低危组 82.4%（7.9%）、中危组 78.3%（5.8%）和高危组 77.6%（7.7%）。•使用凤凰城定义，5 年 bDFS 分别为低危组 74.9%±15.3%、中危组 61.4%±13.2%和高危组 58.0%±11.9%。•有 8 名患者（0.9%）报告有尿失禁。
•全腺体冷冻消融术在老年男性中的应用保持了与年轻男性相似的肿瘤学疗效，且无增加的发病率。
