Congress Reports

7th International Congress of Cryosurgery

11-14 October, 1989, Beijing, China

Participants from 17 countries attended a total of 116 lectures, covering the branches of cryobiology, cryopreservation, cryoimmunology, cryomedicine, cryo- surgery, dermatology, gynaecology, maxillo-facial surgery, ophthalmology, oto- rhino-laryngology and urology.

The majority of urologists were concerned with the treatment of bladder tumour and prostatic carcinoma.

J. Verdier and P. Le Pivert (France) gave details of the cryosound they had devised for introduction with an endoscope. The heat-insulated flexible sound, measuring 2-3 mm in diameter and 1 m in length, is suitable for tissue refrigeration under endoscopic control, down to -60 ~ Satisfactory results are obtained with it in dealing with stage T1 tumours of the bladder.

T. Nagayama (Japan) subjected 90 vesical tumour patients to cryosurgery under endoscopic control. He attained 82 % success in the treatment of stage TI-T2, grade GI-Ga tumours of less than 2 cm diameter. Follow-up tests have shown the recurrence rate to be lower than after TUR.

G. Fontana et al. (Italy) reported on the local refrigeration treatment they had performed with the "needle" sound under ultrasonography, to deal with solitary carcinomatous nodules of the prostate. In a second lecture they described the new combined method they had applied to hormone-resistant prostatic car- cinoma patients in advanced stage. They supplemented the cryotherapy with intralesionally administered microdoses (2000 IU) of beta-interferon. Results are expected from two hypothetical factors: (1) Cryosurgery, in addition to its tumour destructive effect, stimulates the resistance of the organism (cryoimmunotherapy); (2) beta-interferon, on the evidence of in vitro tests, is a powerful activator of the androgen receptor synthesis in carcinomatous cells of the human prostate. As they started to apply the therapy in the last few months, actual results will only be available later.

VSP, Utrecht .4kaddmiai Kiad6, Budapest

Congress Reports

M. Laudi (Italy) combined cryotherapy with the total androgen blockade he had produced with LHRH antagonists and antiandrogens, and studied the effect in advanced cancer of the prostate. His patients showed an 86 ~ four-year survival rate, with 82 ~ urination ability. He concludes that cryotherapy, owing to its immune stimulating effect, is an effective means to stabilize suppression and has the particular advantage of promoting spontaneous urine discharge.

G. Rigondet et al. (France) applied gamma-irradiation therapy following cryocauterization of stage T2 and Ta prostatic cancer. They studied the cryonecrosis that sets in upon refrigeration in the surrounding tissues and found that the ensuing hypervascularity, hypermitosis and young-cell sprouting are producing suitable conditions to apply the gamma therapy. Their results are encouraging as they noticed signs of regression in 30 patients.

Shi Shifang et al. (China) reviewed the experience they had gained in the field of prostatic cryosurgery. Following operation with their own devised appara- tus, they recorded 75 ~ satisfacory results, with subsequent spontaneous urine discharge.

Our own report (Magasi and Simon) covered the experience from 268 cryocautery operations we performed since 1977 in prostatic carcinoma patients, together with analysis of the indications for the intervention. We found that 90 ~o success can be expected, with unimpeded micturition, in stage Ta-T 4 patients of poor general condition, for whom TUR would involve heavier strain and complica- tions and would therefore mean the greater hazard.

Summing up, cryotherapy - like every fresh invented method - is getting delimited for its field of application with clear-cut indications and contraindications so that, in combination with other treatments, it provides additional facilities to deal with cancer of the prostate.

Zs. Simon

International Urology and Nephrolo#y 22, 1990