Oncological and Functional Outcomes for Men Undergoing Salvage Whole-gland Cryoablation for Radiation-resistant Prostate Cancer

Tan, Wei; Kotamarti, Srinath; Ayala, Alexandria; Mahle, Rachael; Chen, Emily; Arcot, Rohith; Chang, Andrew C.; Michael, Zoe; Séguier, Denis; Polascik, Thomas J.

doi:10.1016/j.euo.2023.02.007

Cited by 4 publications

(6 citation statements)

References 19 publications

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“…A recent study analysing biochemical failure after treatment found rates of recurrence at 12 months of 15% and 19% at two years. Our data in terms of recurrence are similar to these studies although longer follow-up is needed (25).…”

Section: Discussionsupporting

confidence: 87%

Salvage cryotherapy for prostate cancer

E Brito,

Pereira,

Ferreira

et al. 2024

Arch Ital Urol Androl

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Background: Most men diagnosed with prostate cancer will be candidates for active treatment and 20 to 50% of patients treated with organ preserving strategies recur within the prostate. Optimal treatment of recurrence is controversial. Prostate cryosurgery has been increasingly used as primary, recurrence and focal treatment for prostate cancer. Methods: We analysed 55 patients submitted to cryotherapy as salvage treatment after recurrence. Results: Study population presented with a mean age of 70.9 ± 6.2 years, mean initial PSA of 7.6 ng/ml and average prostate volume by ultrasound of 43.2 ± 14.7 grams. Mean follow-up was of 18.0 months. Biochemical free survival at one year of follow-up was of 85%. Conclusions: Cryotherapy can be an effective and safe treatment for recurrence after primary curative treatment failure.

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Section: Discussionsupporting

confidence: 87%

Salvage cryotherapy for prostate cancer

E Brito,

Pereira,

Ferreira

et al. 2024

Arch Ital Urol Androl

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“…18 Although there is an improvement in the oncological and functional outcomes of SRP attributed to the advancements in techniques and approaches, 19 the ablation therapies were found to have a competitive therapeutic efficacy as well as better functional outcomes especially preserving urinary continence over SRP in treating failure after BT. 11,13 Our study findings of 2-year and 5year RFS (79.6% and 73%) of BT-SCT and better functional outcomes were equally comparable with the previous studies, further supporting the use of SCT following BT failure. [11][12][13] Advancements in ablation techniques and technologies have increased the use of CRYO among experts as a primary treatment option for PCa.…”

Section: Discussionsupporting

confidence: 85%

“…11,13 Our study findings of 2-year and 5year RFS (79.6% and 73%) of BT-SCT and better functional outcomes were equally comparable with the previous studies, further supporting the use of SCT following BT failure. [11][12][13] Advancements in ablation techniques and technologies have increased the use of CRYO among experts as a primary treatment option for PCa. At 5 years, the rate of biopsy-proven local recurrence after primary CRYO ranges from 20% to 40%.…”

Section: Discussionsupporting

confidence: 85%

“…Salvage cryotherapy (SCT) is well-accepted owing to its favorable functional and oncological outcomes competitive with other salvage approaches. [11][12][13] The Outcomes of SCT following radio-recurrence are well studied, 11,13 but SCT following initial CRYO is emerging as the utilization of ablation and focal therapy become more common. 14 In this study, we compared the oncological and functional outcomes of post-BT-SCT to post-CRYO-SCT to study the therapeutic effects of SCT on radio-resistant cells as compared to second freezing effects on CRYO recurrence cells and to determine the effects of primary treatment on its outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…The high risk of complications associated with local salvage therapy raises a significant concern in treating these patients while achieving oncological control. Salvage cryotherapy (SCT) is well‐accepted owing to its favorable functional and oncological outcomes competitive with other salvage approaches 11–13 . The Outcomes of SCT following radio‐recurrence are well studied, 11,13 but SCT following initial CRYO is emerging as the utilization of ablation and focal therapy become more common 14 .…”

Section: Introductionmentioning

confidence: 99%

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Intermediate‐term oncological and functional outcomes of salvage cryotherapy for the management of prostate cancer recurrence after primary brachytherapy versus primary cryotherapy: A propensity score‐matched analysis

et al. 2023

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BackgroundSalvage cryotherapy (SCT) is widely used to treat prostate cancer (PCa) recurrence after radiotherapy (RT). We studied the intermediate oncological and functional outcomes of patients who underwent SCT following cryotherapy (CRYO‐SCT) recurrence and compare it to recurrence after brachytherapy (BT‐SCT).MethodsAn IRB‐approved retrospective cohort study utilizing patient data from the Cryo On‐Line Data Registry and the Duke PCa database between 1992 and 2016. Biochemical recurrence (BCR) using Phoenix criteria was the primary endpoint assessed at 2‐ and 5‐years post‐SCT. Secondary endpoints assessed functional outcomes including urinary continence, erectile function, and recto‐urethral fistula. Association between treatment and biochemical progression‐free survival was assessed using inverse probability weighted (IPTW) Cox proportional hazards regression. The differences in the secondary functional outcomes were assessed by Pearson's χ2 test or Fisher's exact test, corrected for IPTW.ResultsA total of 194 patients met inclusion criteria. The BCR rate for BT‐SCT and CRYO‐SCT was 23 (20.4%) and 17 (21%) at 2 years and 30 (26.5%) and 22 (27.2%) at 5 years according to Phoenix criteria. There was no statistical difference in 2 years (hazard ratio [HR] 0.9; 95% confidence interval [CI], 0.5–1.7, p = 0.7) or 5‐year BCR (HR: 0.86; 95% CI, 0.5‐1.5, p = 0.6) between the groups. The functional outcomes like urinary continence (p = 0.4), erectile function (p = 0.1), and recto‐urethral fistula (p = 0.3) were not statistically different.ConclusionCRYO‐SCT appears to be well tolerated, with comparable oncological and functional outcomes to patients failing primary BT. The findings also demonstrated that SCT can render a significant number of patients biochemically free of disease after initial CRYO with minimal morbidity. SCT is a viable treatment option to salvage local PCa recurrence following either BT or cryoablation failure.

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