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KMID : 0352819960110010039
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Kosin Medical Journal
1996 Volume.11 No. 1 p.39 ~ p.48
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Usefulness of Cryosurgery on Recurrent or Persistent Prostatic Cancer After Radiation Therapy
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Abstract
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The optimum management for men failing radiation therapy remains controversial in localized prostatic cancer. Recurrent disease when diagnosed after radiotherapy, is most frequently less differentiated and a higher histologic grade
which
generally responds less well to androgen ablation. this study is designed to 57 evaluable patients who have histologically proved recurrent or persistent adenocarcinoma of the prostate following definitive radiation therapy. Age of these
patients
was from 57 to 70 year-old and mean age was 69.6 . Mean recurrent duration after radiation was 4.8 years. Gleason grade in pre-primary radiation therapy was mostly 6(12 cases) and above 9 were 3 cases(7%). Gleason grade in
pre-cryotherapy was mostly 8(17 cases) and above 8 were 25 cases(45%). Compications after cryotherapy were incontinence(42%), and then obstruction symptoms(19%), scrotal edema(14%), gross hematuria(13%), penile pain(12%) were
followed.
After 3 months of cryotherapy, these compications was markedly decreased. PSA level after cryotherapy was decreased in 69 cases(80%) than pre-cryotherapy. Of these, 45 cases(52%) were decreased in range between 4.0ng/ml to 0.3ng/ml
and
20
cases(23%) were decreased below 0.3ng/ml. prostatic biopsy after 6 months of cryotherapys was done in 44 cases. Of these. 27 cases showed no remnant cancer.
In conclusion, cryotherapy for recurrent or persistent localized prostatic cancer following radiation therapy developed no serious complications and decreased PSA level. Also, in prostatic biopsy after 6 months of cryotherapy,
no
remnant prostatic cancer was 61%. Therefore, we think that cryotherapy is useful in recurrent or persistant localized prostatic cancer following radiation therapy.
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KEYWORD
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