Is salvage focal cryotherapy curative treatment for patients with localized recurrent prostate cancer?

Abstract

26 Background: The salvage therapy options for patients with recurrent unilateral prostate cancer after primary radiation, or cryotherapy, are limited. Salvage focal cryotherapy is becoming a more popular treatment option as it has shown success in its disease-free survival rates. Salvage focal cryotherapy enables patients to delay or negate the use of hormone therapy, which has many unfavorable adverse effects. The aim of this study is to report on the curative success of salvage focal cryotherapy in patients with recurrent unilateral prostate cancer. Methods: We identified patients who underwent salvage focal cryotherapy at Winthrop University Hospital between February 2011 and August 2015. Age at the time of treatment, follow-up time, nadir PSA levels, and follow-up treatments were assessed. Results: From 2011 to 2015, 88 patients underwent salvage focal cryoablation. Of these patients, 14 (15.9%) required another therapy treatment after salvage focal cryoablation. Hormone therapy was a necessary treatment for 9 patients. Only 6 patients (6.8%) went on to hormone therapy due to an MRI finding of a local, nodal, or distant relapses. Three (3.4%) patients went on to hormone therapy due to a rise in PSA. Conclusions: Focal salvage therapy is associated with very low risk of clinical and radiographic progression of cancer. In our patients with radiation recurrent cancer, we were able to prevent or delay the use of hormone therapy in the majority of these men. [Table: see text]

Multiparametric MRI Tumor Probability Model for the Detection of Locally Recurrent Prostate Cancer After Radiation Therapy: Pathologic Validation and Comparison With Manual Tumor Delineations

“…The extent of ablation varies from focal with a specified margin around the lesion, to hemi or zonal. 4 A variety of techniques, such as cryotherapy, 5 high intensity focused ultrasound, 6 Iodine-125 (low dose rate [LDR]), 7 and high-dose-rate brachytherapy 8 obtained control rates in line with biochemical disease-free survival outcomes from whole-gland approaches.…”