ORLANDO, FL USA (UroToday.com) - This study group used the Cryo Online Data (COLD) registry to report 5year outcomes for patients who underwent primary cryoablation of the whole prostate.
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The authors risk stratified a total of 1 111 patients who were never treated by prostate cryoablation. Five-year biochemical progression of the patients who were treated by cryoablation for the first time was analyzed using Kaplan Meier method.
For low-, intermediate-, and high-risk patients, the authors found that biochemical progression-free survival rate was 79.9%, 64.1%, and 68.1%, respectively. For patients with PSA of less than 0.4, progression-free survival was 91%, 80.5%, and 77.6%, respectively. For those patients with PSA greater than 0.4, authors found that the 24-hour progression rates were higher than 34%. Continence was preserved for over 90% of patients. Authors also found that 5.9% of patients had urinary retention while 0.5% developed rectal fistula. Thirty-five percent of patients remained potent at 12 months after cryoablation.
The authors concluded that cryoablation therapy produces similar outcomes to surgical and radiation outcomes, regardless of which risk group they are placed in. They also conclude that PSA of above 0.4 is a predictor of biochemical progression in patients treated by whole prostate cryoablation. Therefore, it is necessary to follow these patients more closely to prevent advancing disease.
There are limitations to the study, including its retrospective nature. It may be useful to include other variables into the model in order to assess the real predictive value of PSA of above 0.4. Given there might be confounding variables that might have been omitted, the results will be more powerful if these are included in future analysis.
Presented by David Levy, MD at the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
Cleveland Clinic, Cleveland, OH USA
Written by Garen Abedi, MD, University of California (Irvine), and medical writer for UroToday.com