Abstract
Background
The objective of this study is to describe the technique and evaluate the clinical
value of normal saline (NS) injection for expanding the anterior perirectal space
during prostate cryoablation for prostate cancer (PCa) patients.
Methods
PCa patients who received cryoablation between August 2014 and December 2019 were
enrolled, and the technique of NS injection was adopted. The complications were evaluated.
The prostate-specific antigen (PSA) nadir and biochemical progression-free survival
(bPFS) were measured in localized PCa patients who received cryoablation as the primary
treatment.
Results
A total of 159 PCa patients were included. Among 147 patients with the data of anterior
perirectal space, the median (interquartile range [IQR]) distance of estimated iceball
edge beyond the prostatic capsule was 8.3 (7.0–10.0) mm. No cases of urethrorectal
fistula were reported; 29 patients developed urinary retention and 25 patients presented
scrotal edema. All complications below Clavien-Dindo grade IIIb disappeared within
7 weeks after surgery. Urinary incontinence was reported in 6 patients. Among localized
PCa patients, the median (IQR) follow-up time was 56.5 (36.0–73.5) months. The estimated
5-year bPFS was 82.3% overall, 82.8% for low-to intermediate-risk PCa patients, and
82.1% for high-risk PCa patients. For 52 patients received cryoablation alone, the
median (IQR) PSA nadir was 0.147 (0.027–0.381) ng/mL.
Conclusions
The technique of NS injection for expanding the anterior perirectal space during cryoablation
surgery could avoid urethrorectal fistula and might benefit localized PCa patients
with lower PSA nadir and longer bPFS.
Keywords
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Article info
Publication history
Published online: June 27, 2022
Accepted:
June 23,
2022
Received in revised form:
April 27,
2022
Received:
February 26,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
