Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance: One-Year Follow-Up

Kristin A. Kinsman, Mariah L. White, Lance A. Mynderse, Akira Kawashima, Karen Rampton, Krzysztof R. Gorny, Thomas D. Atwell, Joel P. Felmlee, Matthew R Callstrom, David A Woodrum

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose: Patients who develop prostate cancer after prior abdominal perineal resection are poor surgical candidates, and have limited treatment options. Therefore, our goal is to present results from a single institutional experience of four patients who underwent whole gland MRI-guided cryoablation with a history complicated by prior abdominoperineal resection. Materials and Methods: Four MRI-guided cryoablative treatments (mean age 64, range 59-69 years) for primary and locally recurrent prostate adenocarcinoma were retrospectively reviewed in patients with prior abdominal perineal resection for colorectal cancer (3) and juvenile polyposis (1). Average prostate volume prior to ablation was 23 cc, with an average PSA of 5.6 ng/mL. For each gland, 7-10 cryoprobes were placed approximately 0.5 cm apart in the prostate gland under MRI guidance by a transperineal approach with 3-4 freeze-thaw cycles performed. Each patient had follow up imaging and PSA measurements out to 12 months post ablation. Results: All four patient’s PSA dropped below 0.1 ng/mL at 3-6 month post-ablation and remained at these levels at 12 months. Three of the 4 patients had PSA measurements to 33 months post-ablation, with no evidence of recurrence. No patient developed urinary incontinence due to the whole gland cryoablation. Conclusion: With all four patients in our study having undetectable PSAs 12 months post ablation, and with no patient developing urinary incontinence due to the cryoablation, MRI-guided cryoablation appears to be a promising treatment option in patients who are poor surgical candidates due to prior pelvic surgery and/or radiation.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalCardioVascular and Interventional Radiology
DOIs
StateAccepted/In press - Oct 17 2017

Fingerprint

Cryosurgery
Prostatic Neoplasms
Magnetic Resonance Imaging
Prostate
Urinary Incontinence
Colorectal Neoplasms
Adenocarcinoma
Therapeutics
History
Radiation
Recurrence

Keywords

  • Ablation
  • Cryoablation
  • MRI
  • Prostate cancer
  • Whole prostate gland cryoablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance : One-Year Follow-Up. / Kinsman, Kristin A.; White, Mariah L.; Mynderse, Lance A.; Kawashima, Akira; Rampton, Karen; Gorny, Krzysztof R.; Atwell, Thomas D.; Felmlee, Joel P.; Callstrom, Matthew R; Woodrum, David A.

In: CardioVascular and Interventional Radiology, 17.10.2017, p. 1-6.

Research output: Contribution to journalArticle

Kinsman, Kristin A. ; White, Mariah L. ; Mynderse, Lance A. ; Kawashima, Akira ; Rampton, Karen ; Gorny, Krzysztof R. ; Atwell, Thomas D. ; Felmlee, Joel P. ; Callstrom, Matthew R ; Woodrum, David A. / Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance : One-Year Follow-Up. In: CardioVascular and Interventional Radiology. 2017 ; pp. 1-6.
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abstract = "Purpose: Patients who develop prostate cancer after prior abdominal perineal resection are poor surgical candidates, and have limited treatment options. Therefore, our goal is to present results from a single institutional experience of four patients who underwent whole gland MRI-guided cryoablation with a history complicated by prior abdominoperineal resection. Materials and Methods: Four MRI-guided cryoablative treatments (mean age 64, range 59-69 years) for primary and locally recurrent prostate adenocarcinoma were retrospectively reviewed in patients with prior abdominal perineal resection for colorectal cancer (3) and juvenile polyposis (1). Average prostate volume prior to ablation was 23 cc, with an average PSA of 5.6 ng/mL. For each gland, 7-10 cryoprobes were placed approximately 0.5 cm apart in the prostate gland under MRI guidance by a transperineal approach with 3-4 freeze-thaw cycles performed. Each patient had follow up imaging and PSA measurements out to 12 months post ablation. Results: All four patient’s PSA dropped below 0.1 ng/mL at 3-6 month post-ablation and remained at these levels at 12 months. Three of the 4 patients had PSA measurements to 33 months post-ablation, with no evidence of recurrence. No patient developed urinary incontinence due to the whole gland cryoablation. Conclusion: With all four patients in our study having undetectable PSAs 12 months post ablation, and with no patient developing urinary incontinence due to the cryoablation, MRI-guided cryoablation appears to be a promising treatment option in patients who are poor surgical candidates due to prior pelvic surgery and/or radiation.",
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T1 - Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance

T2 - One-Year Follow-Up

AU - Kinsman, Kristin A.

AU - White, Mariah L.

AU - Mynderse, Lance A.

AU - Kawashima, Akira

AU - Rampton, Karen

AU - Gorny, Krzysztof R.

AU - Atwell, Thomas D.

AU - Felmlee, Joel P.

AU - Callstrom, Matthew R

AU - Woodrum, David A

PY - 2017/10/17

Y1 - 2017/10/17

N2 - Purpose: Patients who develop prostate cancer after prior abdominal perineal resection are poor surgical candidates, and have limited treatment options. Therefore, our goal is to present results from a single institutional experience of four patients who underwent whole gland MRI-guided cryoablation with a history complicated by prior abdominoperineal resection. Materials and Methods: Four MRI-guided cryoablative treatments (mean age 64, range 59-69 years) for primary and locally recurrent prostate adenocarcinoma were retrospectively reviewed in patients with prior abdominal perineal resection for colorectal cancer (3) and juvenile polyposis (1). Average prostate volume prior to ablation was 23 cc, with an average PSA of 5.6 ng/mL. For each gland, 7-10 cryoprobes were placed approximately 0.5 cm apart in the prostate gland under MRI guidance by a transperineal approach with 3-4 freeze-thaw cycles performed. Each patient had follow up imaging and PSA measurements out to 12 months post ablation. Results: All four patient’s PSA dropped below 0.1 ng/mL at 3-6 month post-ablation and remained at these levels at 12 months. Three of the 4 patients had PSA measurements to 33 months post-ablation, with no evidence of recurrence. No patient developed urinary incontinence due to the whole gland cryoablation. Conclusion: With all four patients in our study having undetectable PSAs 12 months post ablation, and with no patient developing urinary incontinence due to the cryoablation, MRI-guided cryoablation appears to be a promising treatment option in patients who are poor surgical candidates due to prior pelvic surgery and/or radiation.

AB - Purpose: Patients who develop prostate cancer after prior abdominal perineal resection are poor surgical candidates, and have limited treatment options. Therefore, our goal is to present results from a single institutional experience of four patients who underwent whole gland MRI-guided cryoablation with a history complicated by prior abdominoperineal resection. Materials and Methods: Four MRI-guided cryoablative treatments (mean age 64, range 59-69 years) for primary and locally recurrent prostate adenocarcinoma were retrospectively reviewed in patients with prior abdominal perineal resection for colorectal cancer (3) and juvenile polyposis (1). Average prostate volume prior to ablation was 23 cc, with an average PSA of 5.6 ng/mL. For each gland, 7-10 cryoprobes were placed approximately 0.5 cm apart in the prostate gland under MRI guidance by a transperineal approach with 3-4 freeze-thaw cycles performed. Each patient had follow up imaging and PSA measurements out to 12 months post ablation. Results: All four patient’s PSA dropped below 0.1 ng/mL at 3-6 month post-ablation and remained at these levels at 12 months. Three of the 4 patients had PSA measurements to 33 months post-ablation, with no evidence of recurrence. No patient developed urinary incontinence due to the whole gland cryoablation. Conclusion: With all four patients in our study having undetectable PSAs 12 months post ablation, and with no patient developing urinary incontinence due to the cryoablation, MRI-guided cryoablation appears to be a promising treatment option in patients who are poor surgical candidates due to prior pelvic surgery and/or radiation.

KW - Ablation

KW - Cryoablation

KW - MRI

KW - Prostate cancer

KW - Whole prostate gland cryoablation

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