Focal cryoablation for unilateral low-intermediate-risk prostate cancer: 63-month mean follow-up results of 41 patients.

To report (1) intermediate-term oncologic and functional outcomes of primary focal cryoablation (FC) in selected patients with clinically unilateral, low-intermediate-risk prostate cancer, and investigate (2) the impact of patient selection criteria at predicting outcomes after FC.

Forty-one patients with unilateral prostate cancer were treated with FC. Patients were stratified using the 2007 Task Force Focal Prostate Cancer Patient selection criteria (Task Force criteria). Posttherapy follow-up included questionnaires, PSA measurement, and TRUS-guided biopsies.

Complete follow-up was available in 40 patients (median follow-up 63 months; range 12-92 months). Compared to precryotherapy PSA level (mean 7. 1 ng/ml), postcryotherapy PSA level (mean 1. 8 ng/ml) dropped by 75 % at 3 months (P < 0. 0001) and this decline persisted throughout the follow-up period, with no significant difference seen across patient selection criteria (P = 0. 859). The treatment failure rate was 10 % (4/40) with no significant difference seen across patient selection criteria (P = 0. 832). Of 32 patients undergoing postcryotherapy biopsy, 7 (22 %) had positive biopsies (2 ipsilateral lobes, 5 contralateral lobes). Patients of Task Force criteria group were less likely to have positive biopsy in contralateral lobe than focal control group (P = 0. 032). Complete continence (no pads) and potency sufficient for intercourse were documented in 97. 6 and 76. 9 % of patients, respectively.

The intermediate-term oncologic efficacy of primary FC in selected patients with clinically unilateral, low-intermediate-risk prostate cancer appears favorable, and the side-effect profile is low. The 2007 Task Force criteria appear to reduce the positive biopsy rate in contralateral lobe after FC.

International urology and nephrology. 2015 Nov 03 [Epub ahead of print]

Huibo Lian, Junlong Zhuang, Rong Yang, Feng Qu, Wei Wang, Tingsheng Lin, Hongqian Guo

Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. , Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. , Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. , Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. , Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. , Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. , Department of Urology, Affiliated Drum Tower Hospital of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, People's Republic of China. 

PubMed