The oncologic results of cryoablation in prostate cancer patients with bone metastases

Si, Ting; Zhi, Guo; Yang, Xueling; Zhang, Weihao; Xing, Wenge

doi:10.1080/02656736.2017.1387940

Cited by 8 publications

(8 citation statements)

References 27 publications

(32 reference statements)

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“…Consistent with a previous study by Si et al [4], the current study demonstrated longer PFS in the patients receiving ADT plus surgery for mPCA than ADT alone. Of note, we found survival bene t for ADT plus cryosurgery only in patients with low metastatic volume, but not high metastatic volume.…”

Section: Discussionsupporting

confidence: 93%

“…The STAMPED trial [3] demonstrated improved overall survival (OS) with ADT plus prostate radiotherapy (RT) to the primary tumor vs. ADT alone only in patients with low-volume disease, but not in patients with high-volume disease. In a retrospective study, Si et al [4] reported signi cant bene ts in both OS and progress-free survival (PFS) in mPCA patients receiving cryosurgery plus ADT than ADT alone. However, there is no a reliable marker to monitor treatment response (sensitivity to cryosurgery or ADT).…”

Section: Introductionmentioning

confidence: 99%

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Circulating Tumor Cells In Patients Undergoing Androgen Deprivation Therapy With Versus Without Cryosurgery For Metastatic Prostate Cancer: : A Retrospective Analysis

Sheng

Guo

Liu

2021

Preprint

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Background: The study aimed to assess the value of circulating tumor cells (CTCs) as a prognostic and treatment response marker in patients undergoing androgen deprivation therapy (ADT) plus cryosurgery vs. ADT alone for metastatic prostate cancer (mPCA).Methods: This retrospective analysis included 43 patients with mPCA: 23 receiving ADT alone (control) and 20 receiving additional cryosurgery (cryosurgery group).CTCs and progression-free survival(PFS) were compared between the two groups. Cox proportional hazards regression was conducted to identify variables associated with PFS.Results: Median PFS was 35 months (IQR: 33-37) in the cryosurgery group vs. 30 months (IQR: 27-32) in the control (p<0.001). CTCs count was significantly lower in the cryosurgery group at both 3 months (z=2.170, p=0.030) and 12 months (z=2.481; p=0.013). In comparison to the baseline, the number of CTCs at both 3 and 12 months was lower in the cryosurgery group (p=0.004 and p<0.001, respectively), but not in the ADT alone group. In multivariate Cox regression, shorter PFS was associated with baseline PSA ≧100 ng/ml (HR 6.584, 95%CI: 5.309-8.166), biopsy Gleason score≧8 (HR 2.064, 95%CI: 1.608-2.650), clinic T stage＞T2b (HR 5.021, 95%CI: 3.925-6.421), number of bone metastases＞3 (HR 3.421, 95%CI: 2.786-4.202), positive CTCs at 3 months post-treatment (HR 6.833, 95%CI: 5.176-9.022), positive CTCs 1 year post-treatment (HR 6.051, 95%CI: 4.347-8.424). Prostate cryosurgery was associated with longer PFS(HR 0.062, 95%CI: 0.048-.080). Conclusions: CTC was a prognostic and treatment response marker for mPCA. ADT plus cryosurgery could reduce CTCs and prolong PFS vs. ADT alone in mPCA patients with low metastatic volume.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Circulating Tumor Cells In Patients Undergoing Androgen Deprivation Therapy With Versus Without Cryosurgery For Metastatic Prostate Cancer: : A Retrospective Analysis

Sheng

Guo

Liu

2021

Preprint

View full text Add to dashboard Cite

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“…Few studies have evaluated the clinical efficacy and oncological outcomes of CA in mPCa, although this treatment is minimally invasive and effective. Si et al [ 16 ] found that CA plus ADT prolonged PFS, CSS, and OS in mPCa patients ( p < 0.01). However, only 30 patients were included in the CA group, and the patients in the ADT group were selected by pair-matched analysis, which might have caused selection bias.…”

Section: Discussionmentioning

confidence: 99%

Prostate cryoablation combined with androgen deprivation therapy for newly diagnosed metastatic prostate cancer: a propensity score-based study

Wang

Deng

et al. 2021

Prostate Cancer Prostatic Dis

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Background Several studies showed that androgen deprivation therapy (ADT) plus local treatment of prostate could improve metastatic prostate cancer (mPCa) patients’ survival. To date there are few studies analyzed the value of prostate cryoablation in mPCa. The objective of our analysis is to evaluate the oncological results and clinical value of prostate cryoablation combined with ADT compared with ADT alone in newly diagnosed mPCa patients. Methods Newly diagnosed mPCa patients undergoing cryoablation plus ADT (group A) between January 2011 and November 2018 were identified. Patients receiving ADT alone (group B) were selected from the same institutional prostate cancer database by propensity score matching based on clinical characteristics. Oncological results and clinical value in symptom control and primary lesion treatment were compared. Results Fifty-four patients were included in each group. Prostate cryoablation was well tolerated. The median follow-up time was 40 (27–53) and 39 (31–54) months in group A and group B, respectively. Patients in group A had a lower median prostate-specific antigen (PSA) nadir (0.025 ng/mL vs. 0.230 ng/mL, p = 0.001), longer median failure-free survival (FFS) (39 months vs. 21 months, p = 0.005), and median metastatic castration-resistant prostate cancer (mCRPC)-free survival (39 months vs. 21 months, p = 0.007). No difference in cancer-specific survival and overall survival was found between the two groups. Multivariate Cox analysis showed combination therapy reduced the risk of FFS by 45.8% (HR = 0.542 [95% CI 0.329–0.893]; p = 0.016). Patients in group A had better clinical relief of urinary symptoms (79.1 vs. 59.1%, p = 0.044) and required less treatment of primary lesions for symptomatic relief (13.0 vs. 31.5%, p = 0.021). Conclusions Prostate cryoablation plus ADT decreases PSA nadir, prolongs FFS and mCRPC-free survival, relieves urinary symptoms and reduces the need for treating primary lesions in newly diagnosed mPCa patients compared to ADT alone.

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“…The STAMPED trial [ 3 ] demonstrated improved overall survival (OS) with ADT plus prostate radiotherapy (RT) to the primary tumor vs. ADT alone only in patients with low-volume disease, but not in patients with high-volume disease. In a retrospective study, Si et al [ 4 ] reported significant benefits in both OS and progress-free survival (PFS) in mPCA patients receiving cryosurgery plus ADT than ADT alone. However, there is no reliable marker to monitor treatment response (sensitivity to cryosurgery or ADT).…”

Section: Introductionmentioning

confidence: 99%

Circulating tumor cells in patients undergoing androgen deprivation therapy with versus without cryosurgery for metastatic prostate cancer: a retrospective analysis

2021

View full text Add to dashboard Cite

Background The study aimed to assess the value of circulating tumor cells (CTCs) as a prognostic and treatment response marker in patients undergoing androgen deprivation therapy (ADT) plus cryosurgery vs. ADT alone for metastatic prostate cancer (mPCA). Methods This retrospective analysis included 43 patients with mPCA: 23 receiving ADT alone (control) and 20 receiving additional cryosurgery (cryosurgery group). CTCs and progression-free survival (PFS) were compared between the two groups. Cox proportional hazards regression was conducted to identify variables associated with PFS. Results Median PFS was 35 months (IQR, 33‑37) in the cryosurgery group vs. 30 months (IQR, 27‑32) in the control (p < 0.001). CTCs count was significantly lower in the cryosurgery group at both 3 months (z = 2.170, p = 0.030) and 12 months (z = 2.481; p = 0.013). In comparison to the baseline, the number of CTCs at both 3 and 12 months was lower in the cryosurgery group (p = 0.004 and p < 0.001, respectively), but not in the ADT alone group. In multivariate Cox regression, shorter PFS was associated with baseline PSA ≧100 ng/ml (HR 6.584, 95% CI, 5.309‑8.166), biopsy Gleason score ≧ 8 (HR 2.064, 95% CI, 1.608‑2.650), clinic T stage>T2b (HR 5.021, 95% CI, 3.925‑6.421), number of bone metastases>3 (HR 3.421, 95% CI, 2.786‑4.202), positive CTCs at 3 months post-treatment (HR 6.833, 95% CI, 5.176‑9.022), positive CTCs 1 year post-treatment (HR 6.051, 95% CI, 4.347‑8.424). Prostate cryosurgery was associated with longer PFS (HR 0.062, 95% CI, 0.048‑.080). Conclusions CTC was a prognostic and treatment response marker for mPCA. ADT plus cryosurgery could reduce CTCs and prolong PFS vs. ADT alone in mPCA patients with low metastatic volume.

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The oncologic results of cryoablation in prostate cancer patients with bone metastases

Abstract: Cryoablation plus ADT might be a treatment option in the multimodality management of metastatic prostate cancer. Further investigations are warranted.

Cited by 8 publications

References 27 publications

Circulating Tumor Cells In Patients Undergoing Androgen Deprivation Therapy With Versus Without Cryosurgery For Metastatic Prostate Cancer: : A Retrospective Analysis

Circulating Tumor Cells In Patients Undergoing Androgen Deprivation Therapy With Versus Without Cryosurgery For Metastatic Prostate Cancer: : A Retrospective Analysis

Prostate cryoablation combined with androgen deprivation therapy for newly diagnosed metastatic prostate cancer: a propensity score-based study

Circulating tumor cells in patients undergoing androgen deprivation therapy with versus without cryosurgery for metastatic prostate cancer: a retrospective analysis

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