To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment.
Data from 110 consecutive patients treated with PGC for localized PCa were collected.
All patients underwent the same standardized follow-up with serum-PSA level and digital rectal examination. Prostate MRI and eventual re-biopsy were performed at twelve months after cryotherapy or in case of suspicion of recurrence. Biochemical recurrence was defined according to Phoenix criteria (PSA nadir + 2 ng/ml). Kaplan-Meier curves and Multivariable Cox Regression analyses were used to predict disease progression, biochemical recurrence- (BCS) and additional treatment-free survival (TFS).
Median age was 75 years (IQR 70-79). PGC was performed in 54 (49.1%) patients with low-risk PCa, 42 (38.1%) with intermediate risk and 14 (12.8%) high risk. At a median follow-up of 36 months, we recorded a BCS and TFS of 75 and 81%, respectively. At 5 years, BCS was 68.5% and CRS 71.5%. High-risk prostate cancer was associated with lower TFS and BCS curves when compared with low-risk group (all p values < .03). A PSA reduction < 50% between preoperative level and nadir resulted as an independent failure predictor for all outcomes evaluated (all p values < .01). Age was not associated with worse outcomes.
PGC could be a valid treatment for low- to intermediate PCa in elderly patients, when a curative approach is suitable in terms of life expectancy and quality of life.
International urology and nephrology. 2023 Feb 21 [Epub ahead of print]
Oscar Selvaggio, Marco Finati, Ugo Giovanni Falagario, Giovanni Silecchia, Marco Recchia, Andrea Alberto Checchia, Paola Milillo, Francesca Sanguedolce, Luca Cindolo, Gian Maria Busetto, Carlo Bettocchi, Luigi Cormio, Giuseppe Carrieri
Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy., Department of Urology and Organ Transplantation, University of Foggia, Foggia, Italy. ., Department of Urology, Bonomo Teaching Hospital, Andria (BAT), Andria, Italy., Department of Diagnostic Imaging, University of Foggia, Foggia, Italy., Department of Pathology, University of Foggia, Foggia, Italy., Department of Urology, "Villa Stuart" Private Hospital, Rome, Italy.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/36809642