PERCUTANEOUS TRANSPERINEAL CRYOSURGICAL ABLATION OF THE PROSTATE FOR THE PRIMARY-TREATMENT OF CLINICAL STAGE C ADENOCARCINOMA OF THE PROSTATE

Objectives. To assess short-term response rate and local tissue destru ctive capabilities of cryosurgical ablation of the prostate (CSAP) in patients with clinical Stage C adenocarcinoma of the prostate. Methods . A retrospective chart review of 62 patients (mean age, 66 years; ran ge, 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 pro state-specific antigens (PSAs), digital rectal examination, and extens ive biopsies at 3 months after CSAP. Results. Average hospital stay wa s 2 days and morbidity was minimal. Biopsy findings showed no residual detectable prostatic tumor in 79% of patients 3 months after 1 CSAP t reatment and in 94.8% 3 months after 1 or 2 treatments. Mean/median 3- month post-operative PSAs for patients with negative biopsy findings w ere 0. 59 +/- 1.66 and 0.10 ng/mL, respectively, compared with 14.0 +/ - 12.1 and 8.90 ng/mL preoperatively. Conclusions. CSAP appears to pro duce controllable, reproducible local tissue destructive effects. Long -term (more than 5 years) crude and disease-free survival rates are no t known for CSAP.