Abstract

You have accessJournal of UrologyCME1 Apr 2023MP63-14 PRELIMINARY RESULTS OF FIRST-IN-HUMAN CRYOTHERAPY FOR NON MUSCLE INVASIVE BLADDER CANCER Gilad Amiel, Omri Falik-Nativ, Kamil Malshy, Omer Sadeh, Michael Mullerad, Eyal Kochavi, and Azik Hoffman Gilad AmielGilad Amiel More articles by this author , Omri Falik-NativOmri Falik-Nativ More articles by this author , Kamil MalshyKamil Malshy More articles by this author , Omer SadehOmer Sadeh More articles by this author , Michael MulleradMichael Mullerad More articles by this author , Eyal KochaviEyal Kochavi More articles by this author , and Azik HoffmanAzik Hoffman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003321.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Initial treatment for Non-Muscle Invasive Bladder Cancer (NMIBC) mostly remains unchanged in recent decades. Utilizing cryotherapy with CO2 is commonly used to treat superficial papillary lesions of the skin for many years. Recently, we have proven its potential in treating urinary epithelial lesions in an animal model. In this study we present our preliminary phase 1 clinical experience and results in treating low grade papillary lesions of the bladder with cryoablation. METHODS: Following local IRB and Ministry of Health approval, 10 patients with up to 3 papillary lesions and a maximum of 10 mm in size were recruited. Exclusion criteria included previous high-grade disease and/or positive cytology. Following an initial routine cystoscopy, the bladder irrigation medium was replaced with CO2 insufflation, and each lesion was treated with 2 cycles of direct spraying of liquid CO2. Each cycle lasted 15 seconds, with 10 seconds of thawing between the treatment cycles. Follow-up cystoscopy and mandatory treatment site biopsy were performed 4-6 weeks after treatment. Routine surveillance with office cystoscopy was performed every 3 months for 1 year thereafter. RESULTS: 8 men and 2 women were included (age 57—89 years). Overall, 14 lesions were treated. No complications were noted during treatment or during follow-up (range 2-14 months). Pathological analysis of the treatment site 4-6 weeks after treatment detected residual low grade TCC only in the very first patient, attributed to suboptimal lesion freezing due to our initial learning curve. The other 13/14 biopsy sites were negative for cancer (93%). CONCLUSIONS: Initial results of cryotherapy utilizing CO2 spraying for small low grade NMIBC is safe and feasible. Pathological analysis confirms efficacy in tumor eradication. This novel treatment may be used as an office procedure and therefore, after further validation studies, offers a potential paradigm shift in the treatment of NMIBC. Source of Funding: Biotechnological Incubator Trendlines, Misgav, Israel © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e876 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gilad Amiel More articles by this author Omri Falik-Nativ More articles by this author Kamil Malshy More articles by this author Omer Sadeh More articles by this author Michael Mullerad More articles by this author Eyal Kochavi More articles by this author Azik Hoffman More articles by this author Expand All Advertisement PDF downloadLoading ...

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