To assess outcomes and complications of partial gland cryoablation (sCRYO) and high-intensity focused ultrasound (sHIFU) for localized radio-recurrent prostate cancer (CaP).
Fifty-one consecutive patients who underwent focal therapy with curative intent for localized radio-recurrent CaP (sCRYO or sHIFU) between 2011 and 2023 were included (IRB# HS-17-00749). Patients were monitored by prostate biopsy (PBx) 6 to 12 months and every 2 year thereafter. The primary endpoint was treatment failure (TF) defined as any radical treatment, systemic therapy, metastases, or CaP-specific mortality. Secondary endpoints were survival-free from (1) biochemical failure (BF, PSA nadir + 2 ng/ml); (2) clinically significant prostate cancer (CSCaP) on follow-up PBx, and (3) radical treatment. Functional outcomes were assessed by the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF-5). The 90-day Clavien-Dindo complications are recorded. Statistically significant if P < 0.05.
A total of 51 patients with radio-recurrent CaP were included. Of these, 41 and 10 underwent sCRYO and sHIFU, respectively. Median baseline characteristics were as follows: age 71 years, PSA 4.48 ng/dl, prostate volume 26 cc. PSA density (PSAD) 0.15 ng/ml2. The short-term free survival rates for TF, CSCaP, Biochemical failure, and radical treatment were 95%, 84%, 76%, and 98%, respectively. The median differences from pre to post-treatment IPSS and IIEF-5 were 0 and 1, respectively. A total of 48 (95%) patients remained continent at follow-up. The 90-day complication rate was 4%.
Partial gland cryotherapy and HIFU for radio-recurrent localized nonmetastatic CaP provide acceptable 2-year oncologic and functional outcomes, with low perioperative complications.
Urologic oncology. 2026 May 22 [Epub ahead of print]
Luis G Medina, Masatomo Kaneko, Lorenzo Storino Ramacciotti, Kevin Chua, Yuta Inoue, Jie Cai, Pierre Halteh, Manju Aron, Duke K Bahn, Osamu Ukimura, Inderbir S Gill, Andre Luis Abreu
Joseph Aresty Department of Urology, Center for Image-Guided Surgery and Focal Therapy, Keck School of Medicine, USC Institute of Urology and Catherine, University of Southern California, Los Angeles, CA; Department of Urology, Hollings Cancer Center Charleston, Medical University of South Carolina, Charleston, SC., Joseph Aresty Department of Urology, Center for Image-Guided Surgery and Focal Therapy, Keck School of Medicine, USC Institute of Urology and Catherine, University of Southern California, Los Angeles, CA; Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA., Joseph Aresty Department of Urology, Center for Image-Guided Surgery and Focal Therapy, Keck School of Medicine, USC Institute of Urology and Catherine, University of Southern California, Los Angeles, CA., Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA., Joseph Aresty Department of Urology, Center for Image-Guided Surgery and Focal Therapy, Keck School of Medicine, USC Institute of Urology and Catherine, University of Southern California, Los Angeles, CA; Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA., Community Memorial Hospital, Prostate Institute of America, Ventura, CA., Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan., Joseph Aresty Department of Urology, Center for Image-Guided Surgery and Focal Therapy, Keck School of Medicine, USC Institute of Urology and Catherine, University of Southern California, Los Angeles, CA; Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address: .