Pilot study to determine safety and short-term outcome of percutaneous cryoablation in the treatment of localized prostate cancer (stages T1C-T3C NO MO).

OBJECTIVE: To assess the effectiveness of cryoablation in localized prostate cancer in our hands. Early end points are biopsy at 5 months and PSA at 12 months follow-up. METHODS: Percutaneous transperineal cryoablation was performed on 30 patients. A urethral warming catheter was used. All cases were newly diagnosed with no prior radiotherapy, or neoadjuvant hormones. A single freeze cycle was used in the first 10 cases and two cycles in the next 20 cases. RESULTS: Twenty-nine of 30 cases are eligible for follow-up. Six of the first 10 patients had negative biopsies, the 4 positive patients have had repeat cryoablation and only 1 patient remains biopsy positive. In cases 11-30, there were two patients with positive biopsies – both retreated. At this time, 27/29 patients (93%) have a negative biopsy after one (23 patients) or two (6 patients) treatments. At 6 months, 20/29 patients (69%) have undetectable PSA; 25/29 have PSA less than 1 ng/ml. At 12 months, 17/23 cases have an undetectable PSA (74%). Complications were minimal; 3 cases (10%) suffered urethral sloughing requiring TURP. CONCLUSION: Early results are very encouraging, showing 93% negative biopsy rate after one (23 patients) or two (6 patients) treatments; PSA is undetectable in 74% (17/23 patients) at 1 year. Early results of cryoablation for prostate cancer are encouraging.