OBJECTIVE: To access the oncologic outcomes and to determine prognostic factors for overall survival (OS), cancer-specific survival (CSS), and biochemical progression-free survival (BPFS) after cryosurgery for clinical stage T3 prostate cancer (PCa).
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METHODS: Between 2002 and 2007, 75 patients with clinical stage T3 prostate cancer received cryosurgery as primary treatment in our institution. No adjuvant treatment was provided until biochemical failure. After biochemical failure, hormone therapy was administered. Kaplan-Meier analysis was used to calculate the OS, CSS, and BPFS. Cox regression was used to identify factors predictive of survival.
RESULTS: cT3a was detected in 60% (45/75) of patients, and cT3b was detected in 40% (30/75) of cases. The five-year OS, CSS, and BPFS rates were 85.3, 92.0, and 48%, respectively. There was a significant difference when comparing the pT3a to pT3b groups for 5-year OS (88.9 vs. 80%, P=0.02) and BPFS (55.6 vs. 36.7%, P=0.01), but there was no difference in CSS (93.3 vs. 90%, P=0.63). Stage, Gleason score, and nadir PSA were associated with BPFS, while Gleason score and nadir PSA were the most significant predictors for CSS.
CONCLUSIONS: Cryosurgery could offer good 5-year OS, CSS, and BPFS rates for cT3 PCa, and there was no difference between T3a and T3b for CSS. Gleason score and nadir PSA were the most significant predictors of survival. Further clinical trials are warranted for evaluating the role of cryosurgery for cT3 prostate cancer.
Guo Z, Si T, Yang X, Xu Y. Are you the author?
Department of interventional therapy, Tianjin Cancer Hospital, Tianjin Medical University, Huanhu Xi Road, Tianjin, 300060, P.R. China.
Reference: BJU Int. 2014 Aug 28. Epub ahead of print.