LONG-TERM FOLLOW-UP AFTER OPEN PERINEAL CRYOTHERAPY IN PATIENTS WITH LOCALLY CONFINED PROSTATE-CANCER

Objective: Appropriate therapies for locally confined adenocarcinoma o f the prostate are available - but there is as yet no gold standard of therapy. For that reason, old therapeutic regimens are being revised. One such regimen is cryotherapy. Methods: Between 1976 and 1989, 1,25 0 patients were seen with newly diagnosed prostate cancer. Sixty-six p atients of stages T-1c (n = 3), T-2a (n = 32), T-2b (n = 9), T-2c (n = 11), T-3a (n = 4), T-3b (n = 5) and T-3c (n = 2) were treated by open perineal cryotherapy. Mean age was 68 years. Three months after surge ry, transurethral resection of the prostate and/or perineal biopsy was performed. Results: In 66% of patients with stages T-1c-T-2b and in 8 7% of patients with stages T-2c-T-3c, positive biopsies were obtained. To date, 28 patients have died between 3 and 16 years after cryothera py, with a mean survival of 7.2 years. The mean follow-up period of su rvivers (38 patients) is 8.5 years. Complications were: stress-inconti nence in 10%, impotence in 10% and temporary rectoperineal fistula in 8%. Conclusions: Cryosurgery is an effective treatment for locally con fined prostate cancer. With improvement of the procedure, clinical out come may also improve.