Bahn D K, Lee F, Solomon M H, Gontina H, Klionsky D L, Lee F T
Department of Radiology, Crittenton Hospital, Rochester, MI 48307.
Radiology. 1995 Feb;194(2):551-6. doi: 10.1148/radiology.194.2.7529937.
To present early results of cryosurgical ablation of prostate cancer with an ultrasound-guided percutaneous technique.
Cryosurgery was performed in 210 patients; near complete 3- and 6-month follow-up data were available for 130. Androgen ablation therapy was used to decrease the size of the prostate gland for optimal freezing. Prostate-specific antigen (PSA) and prostatic biopsy studies were performed at 3, 6, and 12 months.
Gland volume decreased from 29 cm3 +/- 14.1 to 20.4 cm3 +/- 8.4 (P < .0001) after androgen ablation. Rates of positive biopsy findings at 3, 6, and 12 months were 7.7%, 3.3%, and 2.3%, respectively. Serious complications were minimal and included no deaths, urethrorectal fistulas in five patients, and total incontinence in three. Mean PSA levels decreased from 12.6 +/- 16.1 preoperatively to 0.35 +/- 0.75 at 3 months, 0.54 +/- 1.1 at 6 months, and 0.43 +/- 0.78 at 12 months (persistent cancers excluded).
These preliminary results demonstrate that cryosurgery can cause necrosis of prostate cancer. Long-term results and randomized trials are necessary to determine if this means longer disease-free intervals and increased patient survival compared with results of current therapeutic methods.
介绍经超声引导经皮技术冷冻消融前列腺癌的早期结果。
对210例患者实施了冷冻手术；130例患者有近3个月和6个月的完整随访数据。采用雄激素消融疗法减小前列腺体积以实现最佳冷冻效果。在3个月、6个月和12个月时进行前列腺特异性抗原（PSA）和前列腺活检研究。
雄激素消融后腺体体积从29 cm³±14.1降至20.4 cm³±8.4（P <.0001）。3个月、6个月和12个月时活检阳性率分别为7.7%、3.3%和2.3%。严重并发症极少，无死亡病例，5例患者出现尿道直肠瘘，3例患者出现完全性尿失禁。排除持续性癌症后，平均PSA水平术前为12.6±16.1，3个月时降至0.35±0.75，6个月时为0.54±1.1，12个月时为0.43±0.78。
这些初步结果表明冷冻手术可导致前列腺癌坏死。需要长期结果和随机试验来确定与当前治疗方法相比，这是否意味着更长的无病生存期和更高的患者生存率。
