Prospective Outcome Analysis of the Safety and Efficacy of Partial and Complete Cryoablation in Organ-Confined Prostate Cancer

To determine the rate of complications and change in IPSS and SHIM scores following cryotherapy treatment of low and intermediate risk prostate cancer. Secondary endpoint was change in PSA post-cryotherapy and biopsy-proven recurrence.

Enrollment occurred from 2007-2015 to assess long-term complications of cryotherapy. A prostate biopsy was performed at one year or in the event of biochemical failure. Subjects were staged and graded by standard 12-14 core TRUS biopsy. A subset of subjects underwent additional 3DMB if the cancer was suspected to be downgraded. Analyses of functional outcomes were stratified into focal and non-focal treatment.

Study consisted of 393 men with low and intermediate risk prostate cancer, aged 44-89 years. Patient IPSS scores improved significantly in the non-focal treatment strata at all time points, and after 1 year in the focal strata with a median drop at 1 year of 4 points (p<0.001). No significant difference was detected for a change in pre-procedural SHIM score in either treatment strata after two years (p>0.7). 82 patients (20.9%) had a rise in PSA resulting in biochemical failure. 70 patients had detected recurrence for an overall recurrence rate of 20.4% in 343 patients. 109 patients (27.7%) reported urinary retention and urgency post-cryotherapy, with 15.3% requiring catheterization for up to 3 weeks. 37 patients (9.4%) experienced urethral meatal stricture, and 36 patients (9.2%) reported unresolved new-onset ED.

Complication rates, most significantly erectile dysfunction, are decreased in this study compared those previously reported in the literature for cryotherapy for prostate cancer.

Urology. 2017 Nov 07 [Epub ahead of print]

A Barqawi, E Huebner, K Krughoff, C I O'Donnell

Division of Urology, Department of Surgery, University of Colorado Denver School of Medicine, Aurora, Colorado. Electronic address: ., Division of Urology, Department of Surgery, University of Colorado Denver School of Medicine, Aurora, Colorado.