Cryotherapy for low risk prostate cancer, oncological and functional medium term outcomes : A three center prospective study

Objectives: Analyze the oncologic and functional outcomes in patients affected by low risk prostate cancer underwent prostate cryotherapy. Materiasl and methods: It's a prospective tricentric study of 434 patients treated with prostate cryoablation for low risk prostate cancer. By low risk we refer to the D'Amico's risk classification. Two cycles of freezing/thawing are run for each patient following the technique described by Onik. Results: For the 434 patients, the median age was 66 years with a standard deviation of \uc2\ub1 6.68, the average PSA was 6.17 ng/d/L, the median 5.55 with a standard deviation of \uc2\ub1 2.13, the mean prostate volume was 35.59 cc, the median 34.00 cc, with a standard deviation of \uc2\ub1 7.89. Biochemical failure occurred in 67 patients (15.4%). Pre-operative erectile function in men was distributed as follows: severe in 95 patients (19.2%), moderate in 95 (19.2%), medium-moderate in 180 (36.4%), mild in 92 (18.6%), with no dysfunction in 32 (6.5%) patients. Post-operative erectile function, measured 1 month after cryotherapy, was distributed as follows: severe in 321 (65%) patients, moderate in 69 (14%), medium-moderate in 79 (16%), mild in 23 (4.7%), and no dysfunction in only 2 patients (0.4%). Post-operative erectile function after 3 months was distributed as follows: severe in 233 (47.2%) patients, moderate in 66 (13.4%), medium-moderate in 122 (24.7%), mild in 65 (13.2%), and no dysfunction in 8 patients (1.6%). Urinary incontinence was present in 21 patients (4.8%) after 3 months while it dropped to 13 patients (2.9%) after 6 months. Conclusions: Cryotherapy in the treatment of prostate cancer remains a viable alternative. The availability of new cryoprobes and the use of new diagnostic means such as fusion magnetic resonance will make this more precise and more effective method

Ajustamento de observações: uma interpretação geométrica para o método dos mínimos quadrados

O Método dos Mínimos Quadrados (MMQ) é um dos critérios mais utilizados para o ajustamento de informações onde o número de observações é superabundante e o sistema de equações, devido à presença de erros no processo experimental de medições, inconsistente. Este método adota como solução única para tais problemas aquela que minimiza a soma do quadrado dos erros aleatórios, e é largamente empregado em aplicações geodésicas. A fundamentação teórica envolvida no MMQ, contendo o desenvolvimento matemático do método, é amplamente difundida na comunidade geodésica. Porém, neste artigo, o objetivo é apresentar uma revisão teórica sobre a interpretação geométrica do MMQ, e uma solução alternativa de cálculo para este, advinda desta interpretação. Dois exemplos também são apresentados, onde a interpretação geométrica foi demonstrada numericamente para problemas envolvendo duas observações e um parâmetro e também quatro observações e dois parâmetros

Orientação exterior de um par estereoscópico Ikonos II com base no modelo não-rigoroso DLT

O crescente avanço tecnológico ocorrido nos últimos anos, tanto da área da Informática, Fotogrametria e também Sensoriamento Remoto, vem contribuindo significativamente para diversas pesquisas sobre extração de informações tridimensionais a partir de imagens de alta resolução. No presente trabalho, uma solução utilizando modelagem não rigorosa baseada na transformação matemática DLT (Direct Linear Transformation) foi utilizada para a orientação exterior de um par estereoscópico de imagens Ikonos II e determinação de coordenadas tridimensionais por intersecção fotogramétrica. O objetivo principal foi o de avaliar o desempenho do modelo na aplicação, como também a obtenção de melhor configuração de pontos de apoio necessários na orientação exterior para fins da determinação de coordenadas tridimensionais por interseção espacial. Os experimentos realizados permitiram recomendar a configuração adequada para a distribuição dos pontos de apoio, onde a exatidão planimétrica foi equivalente a precisão teórica tolerável igual a um pixel de erro nas observações, enquanto a exatidão altimétrica ficou próxima de 1,5 pixels

Retrograde prostate colonization by metastatic gastric cancer following cryoablation for pT3 prostatic carcinoma

Prostatic gland cryoablation (PGC) is a recently developed procedure for treatment of localized prostatic cancer. We report an unusual case of cancer regression following PGC, with retrograde colonization by a diffusely metastazing gastric adenocarcinoma. Thi case confirms that PGC is an important tool in the management of prostatic tumor and that it may be also considered in the tratment of locally invasive (pT3, C) disease

Salvage cryosurgery for recurrent prostate carcinoma after radiotherapy

Cryotherapy is a salvage treatment for patients with biopsy-proved prostatic adenocarcinoma recurrent after radiotherapy. Proper sampling, labeling, and analysis of prostate biopsies allows prompt diagnosis, identification of important prognostic parameters, and planning of an appropriate therapeutic strategy. Whereas androgen-suppressive therapy is associated with only a temporary benefit, transperineal salvage cryosurgery offers a potentially curative option for patients with localized disease, even those with significant comorbidities. Technological advances, including computerized treatment planning and miniaturized cryoprobes, may provide further therapeutic advantages and lower complication rates. Cryotherapy should be included among the established therapeutic options for recurrence after radiotherap

Multiple Renal Tumours: One Step Beyond Conservative Management

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[Echography in minimally invasive surgery]

Thanks to the great development of laparoscopic surgery and his continuous technical evolution, echography plays more and more important role in the pre- and intraoperative diagnosis. In the hepato-pancreatic pathology the use of the laparoscopic echography reduces clearly the role of laparotomic exploration. In laparoscopic surgery of rectal-colon, the echography is more specific and sensitive in compared with pre-operative MR and CT to individualize liver metastasis, to locate them. This allows the treatment of such lesions through the cryosurgery. In pancreatic lesions such method plays a non releasable role in tumors staging, giving essential elements to the surgeon to operate and for a better definition of operative strategy. Also in the adrenal masses surgery, laparoscopic echography reveals very useful especially in the anatomical structures identification (i.e. renal vein and entrance of the left adrenal vein) in the patients already operated or obese. In the preoperative study of rectal tumors the use of rotating and transrectal probes allows to define the degree of infiltration of the lesion and to perform a mini-invasive treatment through endoscopic transanal microsurgery with the radiochemotherapy. Thus echography in mini-invasive surgery has an unreplaceable role both in diagnosis as in evaluation of the parameter of therapeutical approach

Histopathology of the frozen prostate: the microscopic bases of prostatic carcinoma cryoablation

In the last few years percutaneous cryoablation of the prostate has been reintroduced as an alternative means to prostatic carcinoma. Advantages of the technique include local effectiveness in eradicating tumors, minimal morbidity rate and lower costs when compared to radical surgery. We report a stydy documenting the histopathological changes seen in 317 biopsies obtained from 30 patients treated with cryosurgicsl ablation for prostate cancer