SUO 2017: Primary Focal Cryoablation For Low-, Intermediate- And High-risk Prostate Cancer

Washington, DC ( Introduction: In this study the authors aimed to evaluate the oncologic and functional outcomes of primary focal cryoablation (PFC) for low-, intermediate- and high-risk prostate cancer (PCa) patients.

Methods: This was a retrospective study of 177 men that underwent PFC, from 2002 to 2016 for clinically localized PCa, from a single center database. The percentage PSA decrease at 6 months of follow up was recorded. Five year free-survival (FS) rates were evaluated and defined as follows: Biochemical failure (BFFS = PSA nadir +2.0ng/mL); prostate cancer (PCaFS = Gleason score > 7 on follow up biopsy); salvage treatment (STFS = any salvage treatment after PFC). Continence was defined as use of no pads and potency defined as the ability to have intercourse. High risk PCa patients had pre-PFC work up to rule out metastatic disease. No patients had adjuvant androgen deprivation therapy.

Results: The median (IQR) age, PSA, prostate volume and median follow up time were 66 (61-73) years, 6.4 (4.2-9.1) ng/ml, 40 (31-50) cc and 33 (17-56) months. No patient developed metastasis or died during the follow-up period. No rectal fistulas had occurred. Continence and potency were retained in 98% and 73% of the patients, respectively.

Conclusion: Despite the small sample size and retrospective nature of this study, the authors carefully concluded that PFC for low-, intermediate-, and high-risk prostate cancer provides acceptable oncologic and functional outcomes. Obviously larger prospective trial should be performed before this recommendation can be fully accepted.

Speaker: Masakatsu Oishi, USC institute of Urology, Los Angeles, CA, USA

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, @GoldbergHanan, at the 18th Annual Meeting of the Society of Urologic Oncology, November 29-December 1, 2017 – Washington, DC