Histological changes in prostate biopsies after salvage cryotherapy: effect of chronology and the method of biopsy

OBJECTIVES To examine changes in prostate biopsies at different intervals after salvage cryotherapy and the effect of biopsy type (transrectal ultrasonography‐guided vs transurethral resection, TUR), as the sequence and extent of histological changes occurring in the prostate after salvage cryothera...

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Bibliographic Details
Published in:BJU international 2006-09, Vol.98 (3), p.554-558
Main Authors: IZAWA, JONATHAN I., BUSBY, J. ERIK, MORGANSTERN, NORA, VAKAR‐LOPEZ, FUNDA, SCOTT, SHELLIE M., PISTERS, LOUIS L.
Format: Article
Language:English
Subjects:
Analysis of Variance
Biological and medical sciences
Biopsy, Needle - methods
cryosurgery
Cryotherapy - methods
Follow-Up Studies
Humans
Male
Medical sciences
Nephrology. Urinary tract diseases
Prostate - pathology
prostate cancer
prostate carcinoma
Prostate-Specific Antigen - blood
Prostatic Neoplasms - pathology
Prostatic Neoplasms - therapy
salvage cryotherapy
Salvage Therapy - methods
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Time Factors
Tumors of the urinary system
Urinary tract. Prostate gland
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Summary:OBJECTIVES To examine changes in prostate biopsies at different intervals after salvage cryotherapy and the effect of biopsy type (transrectal ultrasonography‐guided vs transurethral resection, TUR), as the sequence and extent of histological changes occurring in the prostate after salvage cryotherapy for local failure of prostate cancer treatment are unknown. PATIENTS AND METHODS In all, 158 prostate biopsies from 150 patients were examined histologically after salvage cryotherapy for prostate cancer after radiotherapy had failed. Specimens were grouped by time from cryotherapy and biopsy technique. RESULTS Biopsies showed hyalinization, necrosis, inflammation and residual cancer. Hyalinization became predominant over time, most notably in biopsies with no residual cancer. Core biopsies showed more hyalinization and regenerating glands, while TUR biopsies showed more necrosis and inflammation. CONCLUSIONS Tissue cryo‐injury and reactive changes last for >1 year; more extensive cryo‐injury suggests more effective cancer ablation. A long‐term follow‐up is necessary, as prostate cancer might remain indolent for >1 year.
ISSN:1464-4096
1464-410X
DOI:10.1111/j.1464-410X.2006.06347.x