Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
J Endourol. 2021 Sep;35(9):1290-1299. doi: 10.1089/end.2020.0740. Epub 2021 Mar 16.
We aim at reporting the functional and oncological outcomes in men with localized prostate cancer who underwent individualized partial gland cryoablation of the prostate by using validated quality-of-life instruments. We retrospectively reviewed our cryosurgery database between July 2003 and September 2019 for men who were treated with individualized partial gland cryoablation of the prostate at our tertiary care center. Baseline and periodic urinary and sexual function surveys were administered throughout the post-treatment period. A total of 82 men were included in the study. Median follow-up was 28 months (interquartile range: 10.5-59.3 months). A total of 71 men underwent primary individualized partial gland cryoablation, whereas 11 men underwent salvage partial gland ablation. Failure-free survival at 1 to 5 years was 98%, 89%, 84%, 75%, and 75% in the primary therapy group, and 100%, 80%, and 40% in the salvage group at 1 to 3 years, respectively. In the primary therapy group, all 71 patients remained free of pads at 3 months and throughout the follow-up period. Men who had undergone primary focal cryoablation had a higher post-treatment International Index of Erectile Function (IIEF) score, followed by men treated with primary hemi-cryoablation and primary subtotal cryoablation. The American Urological Association (AUA) symptom scores decreased regardless of the type of partial gland ablation performed, with subtotal ablation having the lowest score compared with hemiablation and focal cryoablation. No patient developed a fistula in the primary group, and 1 (9%) patient developed a fistula in the salvage group. Individualized partial gland cryoablation of the prostate is able to achieve excellent oncological and functional outcomes in select men with localized prostate cancer.
我们旨在报告接受个体化前列腺部分冷冻消融术治疗的局限性前列腺癌患者的功能和肿瘤学结局，这些患者使用经过验证的生活质量工具进行治疗。我们回顾性地审查了我们的冷冻手术数据库，纳入了 2003 年 7 月至 2019 年 9 月在我们的三级保健中心接受个体化前列腺部分冷冻消融术治疗的男性患者。在整个治疗后期间，进行了基线和定期的尿功能和性功能调查。共有 82 名男性纳入研究。中位随访时间为 28 个月（四分位间距：10.5-59.3 个月）。共有 71 名男性接受了原发性个体化前列腺部分冷冻消融术，11 名男性接受了挽救性前列腺部分消融术。原发性治疗组的 1 至 5 年无失败生存率为 98%、89%、84%、75%和 75%，挽救性治疗组的 1 至 3 年无失败生存率为 100%、80%和 40%。在原发性治疗组中，所有 71 例患者在术后 3 个月和整个随访期间均无需使用尿垫。接受原发性局灶性冷冻消融术的患者治疗后国际勃起功能指数（IIEF）评分较高，其次是接受原发性半冷冻消融术和原发性次全冷冻消融术的患者。无论进行何种类型的部分前列腺切除术，美国泌尿外科学会（AUA）症状评分均降低，其中次全切除术的评分最低，低于半切除术和局灶性冷冻消融术。原发性组无患者发生瘘，挽救性组有 1 例（9%）患者发生瘘。个体化前列腺部分冷冻消融术能够为选择的局限性前列腺癌男性患者获得优异的肿瘤学和功能学结局。
