Search Our Scientific Publications & Authors

Int Urol Nephrol 2019 Apr 12. Epub 2019 Apr 12.

Division of Urology, University of Cincinnati Cancer Institute, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0589, Cincinnati, OH, 45267, USA.

Biochemical recurrence of prostate cancer occurs in 25-33% of patients who undergo radiation therapy (RT). Unfortunately, greater than 90% of patients with radiation recurrence undergo androgen deprivation therapy (ADT), despite the detrimental side effect profile and the lack of supporting evidence for ADT use in local recurrence. In patients who experience recurrence after treatment with RT, options for treatment include salvage radical prostatectomy (SRP), salvage cryotherapy (SCT), salvage brachytherapy (SBT), and high-intensity focused ultrasound (HIFU). Read More

J Nucl Med 2019 Apr 6. Epub 2019 Apr 6.

Emory University, United States.

We evaluated F-fluciclovine uptake parameters that correlate with true positivity for local recurrence in non-prostatectomy treated patients. Twenty-one patients (prostate-specific antigen 7.4±6. Read More

Arch Esp Urol 2019 04;72(3):277-282

Lyx Institute of Urology. Madrid. Spain. University Hospital Puerta de Hierro-Majadahonda. Madrid. Spain.

Prostate cancer represents the most commonly diagnosed cancer in men and is the second-leading cause of cancer related death in the United States. Primary treatment for prostate cancer includes radiotherapy or ablative procedures such as cryotherapy, and high-intensity focused ultrasound (HIFU). Unfortunately, a large proportion of these patients, especially with high risk features, may experience disease recurrence within 10 years. Read More

Eur Urol 2019 Mar 20. Epub 2019 Mar 20.

Urology Centre, Guy's and St. Thomas NHS Foundation Trust, London, UK. Electronic address:

There are few data on the outcomes and toxicity of radical prostatectomy (RP) among men experiencing local recurrence of prostate cancer (PC) following focal therapy (FT). To characterise perioperative, oncological, and functional outcomes after salvage robot-assisted RP (S-RALP) and determine the risk factors for S-RALP failure, we conducted a multicentre cohort study of 82 patients undergoing S-RALP after FT. All had histological confirmation of PC recurrence, with metastatic disease excluded using pelvic magnetic resonance imaging, a bone scan, and/or positron emission tomography/computed tomography. Read More

Curr Opin Oncol 2019 May;31(3):200-206

Urologic Oncology Branch (UOB), National Cancer Institute (NCI).

Purpose Of Review: Radical treatments for prostate cancer are associated with significant morbidity, including incontinence and erectile dysfunction. Advances in the field of prostate MRI and desire to reduce treatment morbidities have led to a rapid growth in focal treatments for prostate cancer. Here, we review novel focal prostate cancer treatments and their associated recent clinical data, with a particular focus on data reported within the last 24 months. Read More

Urology 2019 Feb 25. Epub 2019 Feb 25.

Columbia University Medical Center, New York, NY. Electronic address:

Objective: To evaluate the quality of web-based information on ablative therapies for prostate cancer METHODS: The two most common search engines (Google and Bing) were queried for the following terms: "prostate cancer" + "HIFU" and "cryotherapy", respectively. The top 50 websites for each were obtained. Websites were characterized and analyzed regarding their accuracy and completeness of information using criteria determined a priori. Read More

World J Urol 2019 Feb 20. Epub 2019 Feb 20.

Department of Urology, Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.

Local recurrent prostate cancer after radical treatment is found in the majority of men with a rising PSA. Salvage treatment procedures for recurrent disease, such as radiation therapy and ablative procedures, can provide long-term responses in well-selected cases. Prostate magnetic resonance imaging (MRI) allows diagnosis and staging, and the value provides information on treatment selection, treatment planning and treatment guidance in local recurrent prostate cancer. Read More

Asian Cardiovasc Thorac Ann 2019 Mar 23;27(3):228-230. Epub 2019 Jan 23.

2 Department of Thoracic Surgery, Liverpool Heart & Chest Hospital, Liverpool, UK.

Endobronchial metastasis from extrapulmonary solid tumors is rare, and endobronchial metastasis from the prostate is even more unusual. An 80-year-old patient presented with significant dyspnea secondary to metastatic stromal cell sarcoma of the prostate, which occluded the right main bronchus. The tumor, causing complete collapse of the right lung, was found on computed tomography and confirmed by bronchoscopy. Read More

Urology 2019 Apr 16;126:158-164. Epub 2019 Jan 16.

Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA. Electronic address:

Objective: To investigate safety, efficacy, and quality of life impact of hemi-gland cryotherapy for clinically-significant prostate cancer (CaP), when patient selection and follow-up includes MRI-guided biopsy.

Methods: Twenty-nine men with unilateral CaP (all clinically significant with prostate volume <60 cc) were enrolled in a prospective observational trial of hemi-gland cryotherapy. Mean patient age was 68. Read More

Clin Transl Oncol 2019 Jan 16. Epub 2019 Jan 16.

The Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.

Objectives: With the maturity of cryotherapy for prostate cancer, the complications after operation are also decreasing, which can improve the prognosis of patients. However, erectile dysfunction (ED) is still one of the main complications after cryotherapy. Therefore, we performed a meta-analysis to evaluate the incidence of erectile dysfunction in patients after cryotherapy. Read More

Eur Urol 2019 Jan 8. Epub 2019 Jan 8.

Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK; Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Background: Focal cryotherapy can be used to treat patients with clinically significant nonmetastatic prostate cancer to reduce side effects.

Objective: Early-medium-term cancer control and functional outcomes.

Design, Setting, And Participants: A prospective registry-based case series of 122 consecutive patients undergoing focal cryotherapy between October 1, 2013, and November 30, 2016, in five UK centres. Read More

Cancers (Basel) 2018 Dec 3;10(12). Epub 2018 Dec 3.

Department of Radiotherapy, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.

Over the last decades, primary prostate cancer radiotherapy saw improving developments, such as more conformal dose administration and hypofractionated treatment regimens. Still, prostate cancer recurrences after whole-gland radiotherapy remain common, especially in patients with intermediate- to high-risk disease. The vast majority of these patients are treated palliatively with androgen deprivation therapy (ADT), which exposes them to harmful side-effects and is only effective for a limited amount of time. Read More

Int J Urol 2019 02 28;26(2):317-319. Epub 2018 Nov 28.

Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Magn Reson Imaging Clin N Am 2019 Feb 29;27(1):131-138. Epub 2018 Oct 29.

Department of Radiology, University of Chicago, 5841 South Maryland Avenue, Chicago, IL 60637, USA.

MR imaging-guided focal therapy is a viable treatment option for patients with localized prostate cancer. After the identification of a malignant focus in the prostate gland on multiparametric MR imaging, treatment can be directed in a precise fashion to the area of interest. The goal of focal therapy is to eradicate prostate cancer while minimizing complications that can affect quality of life. Read More

Urologe A 2018 Dec;57(12):1490-1493

UroEvidence@Deutsche Gesellschaft für Urologie, Nestorstr. 8-9, 10709, Berlin, Deutschland.

Transl Androl Urol 2018 Sep;7(Suppl 4):S420-S435

Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.

Accurate diagnosis of clinically significant prostate cancer is essential in identifying patients who should be offered treatment with curative intent. Modifications to the Gleason grading system in recent years show that accurate grading and reporting at needle biopsy can improve identification of clinically significant prostate cancers. Extracapsular extension of prostate cancer has been demonstrated to be an adverse prognostic factor with greater risk of metastatic spread than organ-confined disease. Read More

J Clin Oncol 2018 Sep 5:JCO1800606. Epub 2018 Sep 5.

Justin E. Bekelman and Neha Vapiwala, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; R. Bryan Rumble, American Society of Clinical Oncology, Alexandria, VA; Ronald C. Chen, University of North Carolina at Chapel Hill, Chapel Hill; Stephen J. Freedland, Durham VA Medical Center, Durham, NC; Thomas M. Pisansky, Mayo Clinic, Rochester, MN; Antonio Finelli, Princess Margaret Cancer Centre, University Health Network; Andrew Feifer, Trillium Health Partners, University of Toronto; D. Andrew Loblaw, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Paul L. Nguyen, Dana-Farber Cancer Institute, Boston, MA; Scott T. Tagawa, Weill Cornell Medicine, New York, NY; Silke Gillessen, Kantonsspital St Gallen, St Gallen, Switzerland; Todd M. Morgan, University of Michigan, Ann Arbor, MI; Glenn Liu, University of Wisconsin Carbone Cancer Center, Madison, WI; John J. Haluschak, Kettering Medical Center-Pavillon, Kettering; Andrew Stephenson, Cleveland Clinic, Cleveland, OH; Karim Touijer, Memorial Sloan Kettering Cancer Center, New York, NY; Terry Kungel, Maine Coalition to Fight Prostate Cancer, Augusta, ME; and Stephen J. Freedland, Cedars-Sinai Medical Center, Los Angeles, CA.

Purpose In April 2017, the American Urological Association, American Society for Radiation Oncology, and Society of Urologic Oncology released a joint evidence-based practice guideline on clinically localized prostate cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. Methods The Clinically Localized Prostate Cancer guideline was reviewed for developmental rigor by methodologists. Read More

BJU Int 2018 Aug 16. Epub 2018 Aug 16.

Urology Section, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA.

Cryotherapy is a minimally invasive treatment option of prostate cancer that involves freezing of the whole prostate (whole gland therapy) or only the cancer (focal therapy), but it is unclear how effective this is in comparison to standard treatments such as radical prostatectomy and radiotherapy [1,2]. We updated a previously published Cochrane Review to assess the effects of cryotherapy (whole gland or focal) compared with other interventions for primary treatment of clinically localized (cT1-T2) or locally-advanced (cT3) non-metastatic prostate cancer by performing a comprehensive search of multiple databases (CENTRAL, MEDLINE, EMBASE), clinical trial registries and a grey literature repository up to 6 March 2018 [3]. We also searched the reference lists of other relevant publications and conference proceedings. Read More

Clin Genitourin Cancer 2018 10 6;16(5):e1073-e1076. Epub 2018 Jul 6.

Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH.

Background: African-American (AA) men have the greatest incidence of and disease-specific mortality from prostate cancer of any racial group. Although encouraging oncologic and functional outcomes have been reported with prostate cancer cryotherapy, little is known about how ethnicity can potentially affect the oncologic outcomes of primary cryotherapy. We report the oncologic outcomes of primary cryotherapy in AA patients through a matched-pair analysis. Read More

World J Urol 2018 Jul 13. Epub 2018 Jul 13.

University of Central, Florida School of Medicine and Global Robotics Institute, Florida Hospital-Celebration Health, Celebration, FL, USA.

Introduction: While no consensus on the optimal salvage treatment exists, only 3% of these patients will get salvage radical prostatectomies due to the assumed technical challenges of this procedure.

Objectives: Our goal is to analyze the perioperative, oncologic and functional outcomes of patients undergoing salvage robotic-assisted radical prostatectomy (sRARP) after primary treatment failure.

Materials And Methods: Data were prospectively collected and retrospectively reviewed from a combined database of more than 14,800 patients who had undergone RARP. Read More

Med Monatsschr Pharm 2017 May;40(5):192-201

With an incidence of approximately 60,000 per year prostate cancer is the most common malignant neoplasm in men with a relatively low mortality rate and a high mean age of primary diagnosis of about 70 years. The disease remains usually clinically occult over a long period of time and generally manifests primarily in a locally advanced or metastasized stage. Due to screening using the PSA level (prostate specific antigen) in blood serum, diagnosis and therapy nowadays are oftentimes possible at an early stage. Read More

World J Urol 2019 Mar 9;37(3):397-407. Epub 2018 Jun 9.

Division of Urology, Duke University, Durham, NC, USA.

Introduction: Long-term outcomes from large cohorts are not yet available upon which to base recommended follow-up protocols after prostate focal therapy. This is an updated summary of a 2015 SIU-ICUD review of the best available current evidence and expert consensus on guidelines for surveillance after prostate focal therapy.

Methods: We performed a systematic search of the PubMed, Cochrane and Embase databases to identify studies where primary prostate focal therapy was performed to treat prostate cancer. Read More

J Endourol 2018 Sep 31;32(9):791-796. Epub 2018 Jul 31.

4 Glickman Urological Institute , Cleveland Clinic Foundation, Cleveland, Ohio.

Purpose: To define the incidence and risk factors associated with rectourethral fistula (RUF) formation following primary whole-gland cryosurgery using a multicenter centralized registry.

Patients And Methods: The Cryo On-Line Data (COLD) registry was queried for men undergoing primary whole-gland cryotherapy between 1990 and 2014 who developed a RUF. Patient factors and disease parameters were correlated with RUF using chi-square and the t-test. Read More

World J Urol 2019 Mar 25;37(3):409-418. Epub 2018 Jun 25.

Olivia Lodeizen, AMC University Hospital, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands.

Context: In recent years, focal therapy has emerged as a treatment option for a selected group of men with localized prostate cancer. Cryotherapy and high-intensity focused ultrasound (HIFU) are the most investigated types of focal treatment with other options currently under evaluation.

Objective: The objective of the study was to give a comprehensive overview of six available focal treatment options for prostate cancer with their rationale, delivery mechanism, and outcomes. Read More

Am J Mens Health 2018 09 7;12(5):1681-1691. Epub 2018 Jun 7.

1 Department of Clinical and Administrative Pharmacy, Division of Pharmaceutical Health Services, Outcomes, and Policy, College of Pharmacy, University of Georgia, Athens, GA, USA.

The high frequency of treatment-related side effects for men with localized prostate cancer creates uncertainty for treatment outcomes. This study assessed the comparative effectiveness of treatment-related side effects associated with conservative management and cryotherapy in patients with localized prostate cancer. A retrospective longitudinal cohort study was conducted, using the linked data of the Surveillance, Epidemiology, and End Results and Medicare, which included patients diagnosed from 2000 through year 2013, and their Medicare claims information from 2000 through 2014. Read More

Cochrane Database Syst Rev 2018 05 30;5:CD005010. Epub 2018 May 30.

Department of Urology, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju, Gangwon, Korea, South, 26426.

Background: Traditionally, radical prostatectomy and radiotherapy with or without androgen deprivation therapy have been the main treatment options to attempt to cure men with localised or locally advanced prostate cancer. Cryotherapy is an alternative option for treatment of prostate cancer that involves freezing of the whole prostate (whole gland therapy) or only the cancer (focal therapy), but it is unclear how effective this is in comparison to other treatments.

Objectives: To assess the effects of cryotherapy (whole gland or focal) compared with other interventions for primary treatment of clinically localised (cT1-T2) or locally-advanced (cT3) non-metastatic prostate cancer. Read More

Urology 2018 Aug 22;118:241. Epub 2018 May 22.

USC Institute of Urology and The Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA.

Objective: To describe our management strategy for rectourethral fistula (RUF) after focal treatment for prostate cancer (PCa) using 2 cases as an example. Almost 50% of RUFs are associated with energy treatment modalities for PCa. The adjacent damage to healthy tissue along with limited pliability of it makes the success of the repair troublesome. Read More

Gland Surg 2018 Apr;7(2):166-187

Center for Interventional Oncology, National Cancer Institute, Bethesda, MD, USA.

Multiparametric magnetic resonance imaging (mpMRI) of the prostate has allowed clinicians to better visualize and target suspicious lesions during biopsy. Targeted prostate biopsies give a more accurate representation of the true cancer volume and stage so that appropriate treatment or active surveillance can be selected. Advances in technology have led to the development of MRI and ultrasound fusion platforms used for targeted biopsies, monitoring cancer progression, and more recently for the application of focal therapy. Read More

Investig Clin Urol 2018 05 20;59(3):152-157. Epub 2018 Mar 20.

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Purpose: To describe the salvage radical prostatectomy (sRP) experience in patients presenting with recurrent, clinically localized prostate cancer after multiple failed local treatments.

Materials And Methods: Among the 251 sRP performed during 2000-2016, 11 patients had failed multiple local therapies. We describe baseline clinical characteristics at primary cancer diagnosis and prior to sRP, surgical information, complications and oncological outcomes. Read More

Prostate Cancer Prostatic Dis 2018 06 9;21(2):175-186. Epub 2018 May 9.

Department of Urology, Institut Montsouris, Paris, France.

Background: With growing interest in focal therapy (FT) of prostate cancer (PCa) there is an increasing armamentarium of treatment modalities including high-intensity focused ultrasound (HIFU), cryotherapy, focal laser ablation (FLA), irreversible electroporation (IRE), vascular targeted photodynamic therapy (VTP), focal brachytherapy (FBT) and stereotactic ablative radiotherapy (SABR). Currently there are no clear recommendations as to which of these technologies are appropriate for individual patient characteristics. Our intention was to review the literature for special aspects of the different technologies that might be of advantage depending on individual patient and tumour characteristics. Read More

Rofo 2018 Sep 17;190(9):836-846. Epub 2018 Apr 17.

Department of Diagnostic&Interventional Radiology, Philipps-University Marburg, Germany.

Purpose:  Local ablative therapies have become an established treatment option in interventional oncology. Radiofrequency ablation (RFA) and microwave ablation (MWA) are a standard of care in the treatment of hepatocellular carcinoma (HCC). Currently, there is an increasing interest in cryotherapy, one of the oldest ablation techniques. Read More

Minerva Urol Nefrol 2018 Jun 16;70(3):252-263. Epub 2018 Apr 16.

Department of Urology, L'Institut Mutualiste Montsouris, Paris, France -

Introduction: The aim of this study was to review the oncological and functional outcomes of new and established primary focal treatments (FT) for localized prostate cancer (PCa).

Evidence Acquisition: We performed a systematic search of published studies on FT for localized PCa using electronic databases (Medline and Embase). These studies included reports on hemi-ablation, focal ablation and target-ablation. Read More

Cryobiology 2018 06 5;82:88-92. Epub 2018 Apr 5.

Department of Urology, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan, ROC. Electronic address:

Purpose: To investigate the efficacy and safety profile of 12-month adjuvant androgen-deprivation therapy (ADT) following total-gland cryoablation (TGC) in patients with high-risk localized prostate cancer (HRLPC).

Materials And Methods: This open-label randomized trial included 38 HRLPC patients who received TGC between July 2011 and March 2013. Within 4 weeks after TGC, subjects were randomly assigned (1:1) to either the 12-month adjuvant ADT or non-adjuvant ADT group. Read More

Adv Radiat Oncol 2018 Jan-Mar;3(1):52-56. Epub 2017 Sep 27.

Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California.

Purpose: Cryotherapy is an option for the primary treatment of localized prostate cancer, along with radical prostatectomy, external beam radiation therapy, and brachytherapy. Although it is known that local recurrence can occur in >20% of patients treated with primary cryotherapy, unfortunately there is a paucity of data on later salvage treatments. The use of external beam radiation therapy is an attractive option after cryotherapy failure, but there is little data on its efficacy and toxicity. Read More

Prog Urol 2018 Apr 16;28(5):291-301. Epub 2018 Mar 16.

Service d'urologie, groupe hospitalier Paris Saint-Joseph, 18, rue Raymond-Losserand, 75674 Paris cedex 14, France.

Objective: To study the oncologic and functional results of salvage cryotherapy after failure of external radiotherapy and brachytherapy.

Materials And Methods: Patients treated by total salvage cryotherapy (3rd generation) in 2 centers (Groupe Hospitalier Saint-Joseph in Paris and Clinique Jule-Verne Nantes) in between January 2008 and April 2016 were included. The biochemical recurrence-free survival (BRFS) was calculated using the Phoenix criteria (PSA>nadir+2ng/mL). Read More

Phys Med Biol 2018 03 21;63(6):064002. Epub 2018 Mar 21.

Tomowave Laboratories, Inc., 6550 Mapleridge St, Ste 124, Houston, TX 77081-4629, United States of America. Present address: Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States of America.

The objective of this study is to demonstrate in vivo the feasibility of optoacoustic temperature imaging during cryotherapy of prostate cancer. We developed a preclinical prototype optoacoustic temperature imager that included pulsed optical excitation at a wavelength of 805 nm, a modified clinical transrectal ultrasound probe, a parallel data acquisition system, image processing and visualization software. Cryotherapy of a canine prostate was performed in vivo using a commercial clinical system, Cryocare CS, with an integrated ultrasound imaging. Read More

Cancer Control 2018 Jan-Mar;25(1):1073274818757418

1 Department of Biological Sciences, State University of New York at Binghamton, Binghamton, NY, USA.

Vitamin D (VD) is an effective adjunctive agent, enhancing the destructive effects of freezing in prostate cancer cryoablation studies. We investigated whether dose escalation of VD over several weeks, to model the increase in physiological VD levels if an oral supplement were prescribed, would be as or more effective than a single treatment 1 to 2 days prior to freezing. PC-3 cells in log phase growth to model aggressive, highly metabolically active prostate cancer were exposed to a gradually increasing dose of VD to a final dose of 80 nM over a 4-week period, maintained for 2 weeks at 80 nM, and then exposed to mild sublethal freezing temperatures. Read More

Rev Urol 2017 ;19(4):268-272

Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center New York, NY.

Salvage treatment options after localized primary treatment failure of prostate cancer are limited and associated with risk for serious complications. We report on the management details of a 57-year-old African American man treated with partial-gland ablation using irreversible electroporation following local recurrence after brachytherapy and prior salvage cryoablation. Therapeutic and functional outcomes were assessed by conventional means, including serum prostate-specific antigen values and prostate biopsy results. Read More

Urology 2018 03 23;113:110-118. Epub 2017 Dec 23.

Stony Brook University School of Medicine, Stony Brook, NY; Department of Urology, NYU-Winthrop Hospital, Mineola, NY.

Objective: To investigate the effects of focal (hemiablation) or total cryotherapy and minimum tumor temperature on patient-reported quality of life (QoL) in patients with prostate cancer.

Methods: An Institutional Review Board-approved database was reviewed for patients who underwent cryotherapy or active surveillance (AS). QoL questionnaire responses were collected and scores were analyzed for differences between focal and total cryotherapy and between very cold (<-76°C) and moderate-cold (≥-76°C) minimum tumor temperatures. Read More

Urol Oncol 2018 02 23;36(2):67-76. Epub 2017 Dec 23.

Department of Urology, University College London Hospital NHS Foundation Trust, London, UK.

Objectives: To systematically review erectile function (EF) outcomes following primary whole gland (WG) and focal ablative therapies for localized prostate cancer to ascertain whether the treatment modality or intended treatment volume affects the time taken to recover baseline EF.

Method And Materials: A systematic review was performed according to the preferred reporting items for systematic review and meta-analysis statement. Inclusion criteria were men with localized prostate cancer treated with primary, ablative therapy. Read More

Curr Opin Urol 2018 03;28(2):93-101

UCLA Department of Urology, David Geffen School of Medicine, Los Angeles, California, USA.

Purpose Of Review: Options for prostate cancer management are rapidly expanding. The recent advent of MRI technology has led to guided prostate biopsies by radiologists working in-bore or by urologists using MR/US fusion technology. The resulting tumor visualization now provides the option of focal therapy. Read More

Prostate Cancer Prostatic Dis 2018 09 7;21(3):355-363. Epub 2017 Dec 7.

Stony Brook University School of Medicine, Stony Brook, NY, 11794, USA.

Background: Technological advancements have led to the success of minimally invasive treatment modalities for prostate cancer such as CyberKnife and Cryotherapy. Here, we investigate patient-reported urinary function, bowel habits, and sexual function in patients following CyberKnife (CK) or Cryotherapy treatment, and compare them with active holistic surveillance (AHS) patients.

Methods: An IRB-approved institutional database was retrospectively reviewed for patients who underwent CK, Cryotherapy, or AHS. Read More

Eur Urol 2018 06 28;73(6):879-887. Epub 2017 Nov 28.

Department of Urology, Mayo Clinic, Rochester, MN, USA. Electronic address:

Background: The Stephenson nomogram is widely used to estimate the success of salvage radiotherapy (sXRT) for prostate cancer (PCa) recurrence after radical prostatectomy (RP).

Objective: To determine whether multiparametric pelvic magnetic resonance imaging (mpMRI) performed for biochemical recurrence after RP improves prognostication of sXRT relative to the Stephenson nomogram.

Design, Setting, And Participants: Men undergoing RP at our institution from 2003 to 2012 who had biochemical recurrence evaluated by mpMRI within 12 mo of sXRT were retrospectively reviewed. Read More

J Oncol Pract 2018 01 1;14(1):e23-e33. Epub 2017 Dec 1.

Icahn School of Medicine at Mount Sinai; Columbia University College of Physicians and Surgeons, New York, NY; and The Ohio State University, Columbus, OH.

Purpose: Black men are more likely to die as a result of prostate cancer than white men, despite effective treatments that improve survival for clinically significant prostate cancer. We undertook this study to identify gaps in prostate cancer care quality, racial disparities in care, and underlying reasons for poorer quality care.

Methods: We identified all black men and random age-matched white men with Gleason scores ≥ 7 diagnosed between 2006 and 2013 at two urban hospitals to determine rates of treatment underuse. Read More

Urol Int 2018 21;100(3):251-262. Epub 2017 Nov 21.

How to manage patients with prostate cancer (PCa) with biochemical recurrence (BCR) following primary curative treatment is a controversial issue. Importantly, this prostate-specific antigen (PSA)-only recurrence is a surrogate neither of PCa-specific survival nor of overall survival. Physicians are therefore challenged with preventing or delaying the onset of clinical progression in those deemed at risk, while avoiding over-treating patients whose disease may never progress beyond PSA-only recurrence. Read More

Clin Med Insights Oncol 2017 7;11:1179554917738765. Epub 2017 Nov 7.

Radiation Oncology Department, University and Spedali Civili Hospital, Brescia, Italy.

Background/aim: Low dose rate brachytherapy has been used as salvage therapy for locally recurrent prostate cancer (PC) after primary external beam radiation therapy (EBRT), along with surgery and cryotherapy. All these techniques, in particular, when applied to the whole gland, involve a relatively high risk of toxicity and may worsen the patient's quality of life. Our aim is to evaluate the results of whole-gland salvage brachytherapy (SBT) after primary EBRT in terms of toxicity, functional outcomes, and efficacy. Read More

World J Urol 2018 Feb 17;36(2):209-213. Epub 2017 Nov 17.

Department of Urology, NYU-Winthrop Hospital, 1300 Franklin Ave, Garden City, Mineola, NY, 11530, USA.

Purpose: We aim to evaluate prostate-specific antigen (PSA) trends in post-primary focal cryotherapy (PFC) patients.

Materials And Methods: This was an institutional review board-approved retrospective study of PFC patients from 2010 to 2015. Patients with at least one post-PFC PSA were included in the study. Read More

Urology 2018 Feb 7;112:126-131. Epub 2017 Nov 7.

Division of Urology, Department of Surgery, University of Colorado Denver School of Medicine, Aurora, CO.

Objective: To determine the rate of complications and change in International Prostate Symptom Score and Sexual Health Inventory for Men scores following cryotherapy treatment of low- and intermediate-risk prostate cancer. The secondary end points were the change in prostate-specific antigen post cryotherapy and biopsy-proven recurrence.

Materials And Methods: Enrollment occurred from 2007 to 2015 to assess long-term complications of cryotherapy. Read More

Cancer Radiother 2017 Dec 6;21(8):799-803. Epub 2017 Nov 6.

Centre Georges-François-Leclerc, rue du Professeur-Marion, 21000 Dijon, France.

Salvage brachytherapy after a first prostate radiation therapy is an emerging technique, which has to be considered in the therapeutic armamentarium in the clinically challenging context of patients with isolated local failure from prostate cancer who may still be considered for cure. These occult failures are more and more frequently diagnosed at an early stage, thanks to targeted biopsies and advances in imaging modalities, such as multiparametric MRI and PET-CT. Salvage brachytherapy benefits from the implantation accuracy of brachytherapy procedures using 3D dosimetry and has resulted in more than 50% tumour control rates with long-term. Read More

Clin Genitourin Cancer 2018 04 16;16(2):e425-e435. Epub 2017 Oct 16.

Department of Urology, Columbia University Medical Center, New York, NY.

Background: To compare oncologic outcomes of different definitive treatment (DT) modalities in a cohort of patients with prostate cancer (PCa) after active surveillance (AS).

Methods: We identified 237 patients with National Comprehensive Cancer Network (NCCN) low- and intermediate-risk prostate cancer diagnosed from 1990 to 2012 who did not undergo immediate DT within 12 months of diagnosis (ie, AS patients as well as watchful waiting and those refusing DT). Charts were examined for clinical/pathologic data and type of DT: surgery (RP), radiation including brachytherapy (XRT), cryotherapy, and androgen deprivation therapy monotherapy (ADT). Read More