Miller R J, Cohen J K, Merlotti L A
Department of Surgery/Division of Urology, Allegheny General Hospital, Pittsburgh, Pennsylvania.
Urology. 1994 Aug;44(2):170-4. doi: 10.1016/s0090-4295(94)80122-3.
To assess short-term response rate and local tissue destructive capabilities of cryosurgical ablation of the prostate (CSAP) in patients with clinical Stage C adenocarcinoma of the prostate.
A retrospective chart review of 62 patients (mean age, 66 years; range, 49 to 79 years) treated on an institutional review board approved protocol at Allegheny General Hospital between June 1990 and December 1993 was performed. Standard follow-up examination included serial prostate-specific antigens (PSAs), digital rectal examination, and extensive biopsies at 3 months after CSAP.
Average hospital stay was 2 days and morbidity was minimal. Biopsy findings showed no residual detectable prostatic tumor in 79% of patients 3 months after 1 CSAP treatment and in 94.8% 3 months after 1 or 2 treatments. Mean/median 3-month postoperative PSAs for patients with negative biopsy findings were 0.59 +/- 1.66 and 0.10 ng/mL, respectively, compared with 14.0 +/- 12.1 and 8.90 ng/mL preoperatively.
CSAP appears to produce controllable, reproducible local tissue destructive effects. Long-term (more than 5 years) crude and disease-free survival rates are not known for CSAP.
评估前列腺冷冻消融术（CSAP）对临床C期前列腺腺癌患者的短期缓解率及局部组织破坏能力。
对1990年6月至1993年12月在阿勒格尼综合医院按照机构审查委员会批准方案接受治疗的62例患者（平均年龄66岁，范围49至79岁）进行回顾性病历审查。标准随访检查包括系列前列腺特异性抗原（PSA）检测、直肠指检以及CSAP术后3个月时的广泛活检。
平均住院时间为2天，并发症极少。活检结果显示，单次CSAP治疗后3个月，79%的患者未检测到残留前列腺肿瘤；1次或2次治疗后3个月，这一比例为94.8%。活检结果为阴性的患者术后3个月PSA的均值/中位数分别为0.59±1.66和0.10 ng/mL，术前则为14.0±12.1和8.90 ng/mL。
CSAP似乎能产生可控、可重复的局部组织破坏效果。CSAP的长期（超过5年）总生存率和无病生存率尚不清楚。
