(UroToday.com) The 2025 South Central AUA annual meeting included a session on prostate cancer, featuring a presentation from Dr. Eusebio Luna Velasquez discussing a real-world analysis of trends, functional, and oncologic outcomes of prostate cancer gland ablation for localized prostate cancer. Prostate gland ablation aims to minimize urinary and sexual side effects of conventional prostate cancer treatments while preserving oncologic efficacy. In this study, presented at the 2025 South Central AUA, Dr. Velasquez and colleagues evaluated the functional and oncologic outcomes of prostate gland ablation compared to radical prostatectomy, along with prostate gland ablation trends, and predictive factors for undergoing the procedure.
This retrospective cohort study used the TriNetX Global Collaborative Network to analyze localized prostate cancer (T1–T3a, N0, M0) patients treated with prostate gland ablation, radical prostatectomy, or external beam radiotherapy from 2010 to 2023. It assessed functional outcomes (2 and 2–5 years post-prostate gland ablation), 5-year failure free survival, treatment trends, prostate gland ablation predictors using propensity score matching, Kaplan-Meier analysis, and Cox regression.
Among 214,411 patients, prostate gland ablation was associated with lower early (0–2 years) risk of erectile dysfunction (HR 0.66, 95% CI 0.58–0.75) and urinary incontinence (HR 0.51, 95% CI 0.42–0.62) versus radical prostatectomy, but higher urinary retention (HR 2.80, 95% CI 2.34–3.45). Notably, during this later follow-up period, prostate gland ablation showed association with a lower risk of erectile dysfunction compared to external beam radiotherapy (HR 0.70, 95% CI 0.49-0.98):
Five-year failure free survival was lower for prostate gland ablation than radical prostatectomy (73.4% versus 86.9%, p < 0.0001) and external beam radiotherapy (73.3% versus 88.5%, p < 0.0001):
Dr. Velasquez concluded this presentation discussing a real-world analysis of trends, functional, and oncologic outcomes of prostate cancer gland ablation for localized prostate cancer with the following take home messages:
- Prostate gland ablation was associated with short-term reduced risks of erectile dysfunction and urinary incontinence compared to radical prostatectomy
- A delayed functional benefit in erectile function was also observed compared to external beam radiotherapy
- However, prostate gland ablation was associated with lower five-year failure free survival rates than radical prostatectomy and external beam radiotherapy, highlighting its limited oncologic durability
Presented by: Eusebio Luna Velasquez, Houston Methodist Hospital, Houston, TX
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 South Central American Urological Association (AUA) Annual Meeting, Orlando, FL, Wed, Sept 10 – Sat, Sept 13, 2025.