Oncological and functional outcomes of men undergoing primary whole gland cryoablation of the prostate: A 20-year experience.

Abstract

BACKGROUND:

This study reports the oncological and functional outcomes in men with localized prostate cancer (Pca) who were treated with primary whole gland cryoablation (WGC) of the prostate.

METHODS:

The authors retrospectively reviewed their prospectively collected cryosurgery database between January 2002 and September 2019 for men who were treated with WGC of the prostate at a tertiary referral center. Primary outcome includes biochemical recurrence-free survival (BRFS). Secondary outcomes include failure-free survival (FFS), metastasis-free survival (MFS) and adverse events.

RESULTS:

A total of 260 men were included in the study. Men having had prior treatment for Pca were excluded. Median follow-up was 107 months (interquartile range [IQR], 68.3-132.5 months). BRFS, FFS, and MFS at 10 years were 84%, 66%, and 96%, respectively. High risk D'Amico classification was associated with a lower BRFS and FFS on multivariable analysis. No patient had any Pca-related death during follow-up. American Urological Association symptoms score and bother index were unchanged following cryoablation. Median International Index of Erectile Function score precryoablation and post-cryoablation was 7 (IQR, 3-11) and 1 (IQR, 1-5), respectively. Stress urinary incontinence, defined as requiring any protective pads only occurred in five patients (2%). No patient developed a fistula. Grade > 2 Clavien-Dindo adverse events occurred in six (2.3%) patients.

CONCLUSION:

WGC of the prostate can achieve excellent oncological and functional outcomes in men with localized Pca at the 10-year mark. Primary WGC may be a good option for men who desire to preserve urinary continence and have an excellent oncologic outcome.

LAY SUMMARY:

Primary whole gland cryoablation is an alternative treatment option to radical prostatectomy and radiotherapy for men with organ-confined prostate cancer. Patients had excellent cancer outcomes 1 years after whole gland cryoablation, and patients with PSA nadir 0.1 ng/ml or lower after treatment were less likely to have disease recurrence.

• Authors: Wei Phin Tan, Srinath Kotamarti, Emily Chen, Rachael Mahle, Rohith Arcot, Andrew Chang, Alexandria Ayala, Zoe Michael, Denis Seguier, Thomas J Polascik
• Journal: Cancer (Cancer) Vol. 128 Issue 21 Pg. 3824-3830 (11 01 2022) ISSN: 1097-0142 [Electronic] United States
• PMID: 36107496 (Publication Type: Journal Article)
• Copyright: © 2022 American Cancer Society.

Chemical References

• Prostate-Specific Antigen

Topics

• Cryosurgery (adverse effects)
• Humans
• Male
• Neoplasm Recurrence, Local (diagnosis)
• Prostate (surgery)
• Prostate-Specific Antigen
• Prostatic Neoplasms
• Retrospective Studies
• Treatment Outcome