TOTAL CRYOSURGICAL DESTRUCTION OF THE PROSTATE vs STANDARD CRYOSURGERY vs RADICAL PERINEAL PROSTATECTOMY "" COMPARISON OF EARLY RESULTS Purpose: To compare the results of treatment of 49 patients who underwent standard cryosurgery of the prostate for the treatment of prostate cancer with 27 patients who had destruction of the urethra during or after the cryosurgery either by subsequent TUR or by total freezing of the prostate (total cryosurgery). These results were compared to a group of 83 radical surgery patients similar in age, stage, grade, and PSA levels to the cryosurgical groups.
Materials and Methods: Patients who underwent cryosurgery included all patients treated by the author for localized prostate cancer after July 1, 1995. The patients who underwent radical perineal prostatectomy were all patients treated by the author's associate during the time of the study and by the author prior to his use of cryosurgery. The standard used for success was a post-treatment PSA of 0.2
or less at six months after the procedure in each case. A stricter standard of success, the 0.0 PSA was also assessed.
Results and Conclusions: Patients who underwent total cryosurgery had a 96% success rate. Those who had standard cryosurgery had a 48.9% success rate. Radical surgery patients had a 73.4% success rate.
Using the stricter parameter of success, the 0.0 PSA, 66.7% of the total cryosurgery group were successfully treated. 16.3% of the standard cryosurgery patients reached a nadir of 0.0. 48.2% of the radical surgery patients reached this level.
It is the author's conclusion that total cryosurgical destruction of the prostate may offer new opportunities for cancer treatment heretofore unrecognized and should undergo more investigational analysis.
INTRODUCTION Cryosurgery is still considered an investigative alternative for the treatment of prostatic cancer in many quarters.1,2 Even its proponents acknowledge its limitations as described by...