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Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study
Our study explored frozen section reliability in prostate cancer (PCa) diagnoses and described surgical steps of a 3D magnetic resonance imaging (MRI)–ultrasound (US)-guided prostate biopsy (PB) and focal cryoablation of the index lesion (IL) in a single-setting procedure. Patients with a suspicious...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305658/ https://www.ncbi.nlm.nih.gov/pubmed/37373967 http://dx.doi.org/10.3390/jpm13060978 |
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author | Misuraca, Leonardo Lugnani, Franco Brassetti, Aldo Cacciatore, Loris Tedesco, Francesco Anceschi, Umberto Bove, Alfredo Maria D’Annunzio, Simone Ferriero, Mariaconsiglia Guaglianone, Salvatore Mastroianni, Riccardo Tuderti, Gabriele Panebianco, Valeria Sentinelli, Steno Simone, Giuseppe |
author_facet | Misuraca, Leonardo Lugnani, Franco Brassetti, Aldo Cacciatore, Loris Tedesco, Francesco Anceschi, Umberto Bove, Alfredo Maria D’Annunzio, Simone Ferriero, Mariaconsiglia Guaglianone, Salvatore Mastroianni, Riccardo Tuderti, Gabriele Panebianco, Valeria Sentinelli, Steno Simone, Giuseppe |
author_sort | Misuraca, Leonardo |
collection | PubMed |
description | Our study explored frozen section reliability in prostate cancer (PCa) diagnoses and described surgical steps of a 3D magnetic resonance imaging (MRI)–ultrasound (US)-guided prostate biopsy (PB) and focal cryoablation of the index lesion (IL) in a single-setting procedure. Patients with a suspicious prostatic specific antigen (PSA) value, with a PIRADS 4 or 5 single lesion, were enrolled for trans perineal 3D MRI–US-guided PB and TRUS-guided focal cryoablation. Three cores were taken from the IL, three cores from the surrounding area, while systematic sampling was performed for the rest of the gland. After confirmation of PCa in frozen sections, focal cryoablation was performed. The 1st-year follow-up schedule included a PSA test at a 3-month interval, MRI 3 months and 1 year postoperatively and PB of the treated area at 1 year. Following the follow-up schedule, an involved PSA test at a 3-month interval and yearly MRI were performed. The PCa diagnosis was histologically confirmed in all three patients with frozen sections. At final histology, a single Gleason score upgrade from 6 (3 + 3) to 7 (3 + 4) was observed. All patients were discharged on postoperative day 1. At the 3-month evaluation, mean PSA values decreased from 12.54 (baseline) to 1.73 ng/mL and MRI images showed complete ablation of the IL in all patients. Urinary continence and potency were preserved in all patients. At the 1-year follow-up, one patient had suspicious ipsilateral recurrence on MRI and underwent a new analogous procedure. Post follow-up was uneventful and PSA remained stable in all patients. Three-dimensional MRI–US-guided frozen sectioning and focal cryoablation of the IL is a step forward towards a “patient-tailored” minimally invasive approach to the diagnosis and cure of PCa. |
format | Online Article Text |
id | pubmed-10305658 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-103056582023-06-29 Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study Misuraca, Leonardo Lugnani, Franco Brassetti, Aldo Cacciatore, Loris Tedesco, Francesco Anceschi, Umberto Bove, Alfredo Maria D’Annunzio, Simone Ferriero, Mariaconsiglia Guaglianone, Salvatore Mastroianni, Riccardo Tuderti, Gabriele Panebianco, Valeria Sentinelli, Steno Simone, Giuseppe J Pers Med Article Our study explored frozen section reliability in prostate cancer (PCa) diagnoses and described surgical steps of a 3D magnetic resonance imaging (MRI)–ultrasound (US)-guided prostate biopsy (PB) and focal cryoablation of the index lesion (IL) in a single-setting procedure. Patients with a suspicious prostatic specific antigen (PSA) value, with a PIRADS 4 or 5 single lesion, were enrolled for trans perineal 3D MRI–US-guided PB and TRUS-guided focal cryoablation. Three cores were taken from the IL, three cores from the surrounding area, while systematic sampling was performed for the rest of the gland. After confirmation of PCa in frozen sections, focal cryoablation was performed. The 1st-year follow-up schedule included a PSA test at a 3-month interval, MRI 3 months and 1 year postoperatively and PB of the treated area at 1 year. Following the follow-up schedule, an involved PSA test at a 3-month interval and yearly MRI were performed. The PCa diagnosis was histologically confirmed in all three patients with frozen sections. At final histology, a single Gleason score upgrade from 6 (3 + 3) to 7 (3 + 4) was observed. All patients were discharged on postoperative day 1. At the 3-month evaluation, mean PSA values decreased from 12.54 (baseline) to 1.73 ng/mL and MRI images showed complete ablation of the IL in all patients. Urinary continence and potency were preserved in all patients. At the 1-year follow-up, one patient had suspicious ipsilateral recurrence on MRI and underwent a new analogous procedure. Post follow-up was uneventful and PSA remained stable in all patients. Three-dimensional MRI–US-guided frozen sectioning and focal cryoablation of the IL is a step forward towards a “patient-tailored” minimally invasive approach to the diagnosis and cure of PCa. MDPI 2023-06-10 /pmc/articles/PMC10305658/ /pubmed/37373967 http://dx.doi.org/10.3390/jpm13060978 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Misuraca, Leonardo Lugnani, Franco Brassetti, Aldo Cacciatore, Loris Tedesco, Francesco Anceschi, Umberto Bove, Alfredo Maria D’Annunzio, Simone Ferriero, Mariaconsiglia Guaglianone, Salvatore Mastroianni, Riccardo Tuderti, Gabriele Panebianco, Valeria Sentinelli, Steno Simone, Giuseppe Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study |
title | Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study |
title_full | Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study |
title_fullStr | Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study |
title_full_unstemmed | Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study |
title_short | Single-Setting 3D MRI/US-Guided Frozen Sectioning and Cryoablation of the Index Lesion: Mid-Term Oncologic and Functional Outcomes from a Pilot Study |
title_sort | single-setting 3d mri/us-guided frozen sectioning and cryoablation of the index lesion: mid-term oncologic and functional outcomes from a pilot study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10305658/ https://www.ncbi.nlm.nih.gov/pubmed/37373967 http://dx.doi.org/10.3390/jpm13060978 |
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