Criteria used for the diagnosis and treatment of recurrent prostate adenocarcinoma after radiotherapy are examined according to recently published studies in the literature. The diagnosis of recurrence is confirmed by the histological test of a biopsy performed due to the gradual increase in prostate-specific antigen (PSA). Proper sampling, nomenclature and analysis of prostate biopsies allow an early diagnosis to identify some important prognostic parameters and to plan the most appropriate therapeutic strategy for every single case. Androgen suppressive therapy only induces a temporary benefit in these patients. Transperineal salvage cryosurgery (SC) represents a recognized effective treatment option. Technological advances, including computerized treatment planning and miniaturized cryoprobes, allow further potential therapeutic advantages and reduce complications. Results of SC are promising even in patients with other comorbidities; therefore, it is useful to include it among therapeutic instruments for failures following radiotherapy.
KaplanI.D., PrestidgeB.R., BagshawM.A., CoxR.S.The importance of tumor control in the treatment of prostatic cancer.J Urol1992; 147: 917–21.
2.
SandlerH.M., DunnR.L., McLaughlinPW. Overall survival after prostate-specific-antigen detected recurrence following conformal radiation therapy.Int J Radiat Oncol Biol Phys2000; 48: 629–33.
3.
SwansonG.P., RiggsM., EarleJ.Failure after primary radiation or surgery for prostate cancer: differences in response to androgen ablation.J Urol2004; 172: 525–8.
4.
ZagrasG.K., von EschenbachA.C., AyalaA.G.Prognostic factors in prostate cancer analysis of 874 patients treated with radiation therapy.Cancer1993; 72: 1709–25.
5.
BrawerM.K.The management of radiation failure in prostate cancer.Reviews Urology2002; 4(Suppl. 2): S1–29.
6.
ChinJ.L., ToumaN., PantlerS.E., GuramKS. Serial biopsy and PSA results on salvage cryoablation for prostate cancer: 5 year results on 142 patients.J Urol2003; 169: 398, A1488.
7.
De la TailleA., KatzA.E.Cryosurgery: is it an effective option for patients failing radiation?Curr Opin Urol2000; 10: 409–13.
8.
HanK.R., CohenJ.K., MillerRJ. Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multicenter experience.J Urol2003; 170: 1126–30.
9.
MuzzonigroG., MinardiD., PolitoMJr.,. Cryoablation of localized prostate neoplasia: assessment of morbidity, complications, and disease recurrence.Eur Urol2001; 39: 99, A368.
10.
BahnD.K., LeeF., SilvermanP., BahnE., BadalamentR., KumarA., GreskiJ., RewcastleJ.C.Salvage cryosurgery for recurrent prostate cancer after radiation therapy: a seven-year follow-up.Clin Prostate Cancer2003; 2: 111–4.
11.
GhafarM.A., JohnsonC.W., de la TailleA. Salvage cryotherapy using an argon based system for prostate cancer locally recurrent after radiation therapy: the Columbia experience.J Urol2001; 166: 1333–8.
12.
OnikG.Image-guided prostate cryosurgery: state of the art.Cancer Control2001; 8: 522–31.
13.
De La TailleA., HayekO., BensonMC. Salvage cryotherapy for recurrent prostate cancer after rdiation therapy: the Columbia experience.Urology2000; 55: 79–84.
14.
PistersL.L., von EschenbachA.C., ScottSM. The efficacy and complications of salvage cryotherapy of the prostate.J Urol1997; 157: 921–5.
15.
MillerR.J.Jr., CohenJ.K., ShumanB., MerlottiL.A.Cancer. Percutaneous, transperineal cryosurgery of the prostate as salvage therapy for post radiation recurrence of adenocarcinoma.Cancer1996; 77: 1510–4.
16.
BalesG.T., WilliamsM.J., SinnerM. Short-term outcomes after cryosurgical ablation of the prostate in men with recurrent prostate carcinoma following radiation therapy.Urology1995; 46: 676–80.
17.
ChinJ.L., ToumaN., PautlerS.E., GuramK.S., BellaA.J., DowneyD.B., MoussaM.Serial histopathology results of salvage cryoablation for prostate cancer after radiation failure.J Urol2003; 170: 1199–202.
18.
LongJ.P., FallikM.L., LaRockD.R., RandW.Preliminary outcomes following cryosurgical ablation of the prostate in patients with clinically localized prostate carcinoma.J Urol1998; 159: 477–84.
19.
LeeF., BahnD.K., McHughTA. Cryosurgery of prostate cancer. Use of adjuvant hormonal therapy and temperature monitoring – one year follow-up.Anticancer Res1997; 17: 1511–6.
20.
LeeF., BahnD.K., BadalamentRA. Cryosurgery for prostate cancer: improved glandular ablation by use of 6 to 8 cryoprobes.Urology1999; 54: 135–40.
21.
MinardiD., GalosiA.B., PolitoMJr. Echoguided prostate cryosurgery: experience after short and medium term follow-up.Arch Ital Urol Androl2000; 72: 270–5.
22.
OnikG., NarayanP., BrunelleR. Saline injection into Denonvilliers’ fascia during prostate cryosurgery.J Min Ther Relat Thec.2000; 9: 423–27.
23.
CytronS., PazA., KravchickS., Shumalinski, MooreJ.Active rectal wall protection using direct transperineal cryo-needles for histologically proven prostate adenocarcinoma.Eur Urol2003; 44: 315–21.
24.
LittrupP.J., ModyA., SparschuR. Prostatic cryotheraphy: ultrasonographic and pathologic correlation in the canine model.Urology1994; 44: 175–183
25.
ShionaraK., RheeB., PrestiJ.C., CarrollP.R.: Cryosurgical treatment of localized prostate cancer: patterns of cancer recurrence.J Urol1997; 158: 2206–9.
26.
AnastasiadisA.G., SachdevR., SalomonL. Comparison of health-related quality of life and prostate-associated symptoms after primary and salvage cryotherapy for prostate cancer.J Cancer Res Clin Oncol2003; 129(12): 676–82.
27.
El SakkaA.I., HassanMU. Effect of cavernous nerve freezing on protein and gene expression on nitric oxide synthase in tha rat penis and pelvic ganglia.J Urol1998; 160: 2245–52.
28.
ShinoharaK., CarrollP.R.Cryotherapy for prostate cancer. In: Campbell's Urology edited by Walsh, Retik, Vaughan, Wein. 8° Edition; vol.3, cap. 93: 3171–81.
29.
ChinJ.L., PautlerSE. Results of salvage cryoablation of the prostate after radiation: identifying predictors of treatment failure and complications.J Urol2001; 165: 1937–42.
30.
GrossfeldG.D., LiY.P., LubeckD.P., CarrollP.R.Patterns of failure after primary local therapy for prostate cancer and rationale for secondary therapy.Urology2002; 60: 57–62.
31.
SungJ., EspirituJi. Fluorodeoxyglucose positron emission tomography studies in diagnosis and staging of clinically advanced prostate cancer.BJU Int2003; 92: 24–7.
32.
ChangC.H., WuH.C., TsaiJ.J., ShenY.Y., ChanglaiS.P., KaoA.Detecting metastatic pelvic lymph nodes by 18F-2-deoxyglucose positron emission tomography in patients with PSA relapse after treatment for localized prostate cancer.Urol Int2003; 70: 311–5.
33.
MuzzonigroG., GalosiA.B.Biological selection criteria for radical prostatectomy.Annals NY Acad Sci2002; 963: 204–212.
34.
AragonaF., PepeP., CandianoG., D'ArrigoL.La prostatectomia di salvataggio dopo radioterapia definitiva.Urologia Pratica2004; 2: 33–8.
35.
Panel AsTRaOC.Consensus statement: guidelines for PSA following radiation therapy.Int J Radiat Oncol Biol Phys1997; 37: 1035–40.
36.
CrookJ.PSA and radiation therapy. In: Prostate Specific Antigen edited by BrawerM.K.Marcel Dekker, 2001, 207–227.
37.
PicchioM., MesaC., LandoniC. Value of (11C)choline-positron emission tomography for re-staging prostate cancer: comparison with (18F) fluorodeoxy-glucose-positron emission tomography.J Urol2003; 169: 1337–40.
38.
BoccardoF., FranzoneP, IntroiniC., NeumaierCE. per l’ Ass.Italiana Oncologia Medica. Linee Guida per il carcinoma della prostata.Editore Intermedia, Roma, 2004.
39.
RogersE., OhoriM., KassabianVS. Salvage radical prostatectomy: outcome measured by serum prostate specific antigens levels.J Urol1995; 46: 676–80.
40.
KubanD.A., SchellhammerP.F.Prognostic significance of postirradiation prostate biopsies.Oncology1993; 7: 29–47.
41.
GalosiA.B., MuzzonigroG.Methods to obtain more clinical and pathological information from needle core biopsy of prostate gland: our experience.Ann N Y Acad Sci2002; 963: 218–20.
42.
Boccon-GibodL., van der KwastT.H., MontironiR., Boccon-GibodL., BonoA.Handling and pathology reporting of prostate biopsies.Eur Urol2004; 46: 177–81.
43.
ChengL., ChevilleJ.C., BostwickD.G.Diagnosis of prostate cancer in needle biopsies after radiation therapy.Am J Surg Pathol1999; 23: 1173–83.
44.
IzawaJ.I., MorgansternN., ChanD.M., LevyL.B., ScottS.M., PistersL.L.Incomplete glandular ablation after salvage cryotherapy for recurrent prostate cancer after radiotherapy.Int J Radiat Oncol Biol Phys2003; 56: 468–72.
