Emerging Role of Hemigland Cryoablation With MRI-Guided Biopsy for Prostate Cancer
Posted: Wednesday, December 16, 2020
When evaluated by serial MRI-guided biopsy, hemigland cryoablation yielded a high rate of control of prostate cancer, according to a study published in The Journal of Urology. In fact, 82% of men who underwent the freezing procedure were free of cancer at their 18-month follow-up. “MRI allows most lesions of clinically significant prostate cancer to be visualized, providing a targeted path to precise biopsy and focal treatment,” according to Ryan Chuang, MD, and colleagues at the University of California, Los Angeles.
In an observational trial of 61 men with unilateral prostate cancer grade 2 or higher, hemigland cryoablation was offered in place of surgery or radiation therapy. The average age of patients was 69, and most were White (80%). Using follow-up imaging procedures and MRI-guided biopsies, results were assessed at 6 months’ follow-up for all patients and again at 18 months for 27 patients.
At both follow-up periods, biopsies showed no evidence of prostate cancer in more than 80% of patients (50 patients at 6 months and 22 patients at 18 months). In addition, a new focus of cancer was detected in the contralateral prostate in just 1 of 27 men during follow-up. No intraoperative complications were reported, and treatment-related postoperative complications were “generally mild and short-lived,” according to the study authors.
The results of this trial demonstrate a follow-up biopsy as “the most important criterion of success” in evaluating the results of hemigland cryoablation. Although the proper role of hemigland ablation in prostate cancer treatment remains under study, the authors concluded: “As use of MRI-guided biopsy increases, with resulting improved accuracy of prostate tissue characterization, numbers of candidates for partial gland ablation are expected to rise.”
Disclosure: The study authors reported no conflicts of interest.