Primary Whole-gland Cryoablation for Prostate Cancer: Biochemical Failure and Clinical Recurrence at 5.6 Years of Follow-up

Publication date: Available online 28 September 2018Source: European UrologyAuthor(s): Masakatsu Oishi, Inderbir S. Gill, Akbar N. Ashrafi, Michael Lin-Brande, Nima Nassiri, Toshitaka Shin, Alfredo Bove, Giovanni E. Cacciamani, Osamu Ukimura, Duke K. Bahn, Andre Luis de Castro AbreuAbstractWe retrospectively evaluated complications and functional and oncologic outcomes of 94 consecutive men who underwent primary whole-gland cryoablation for localized prostate cancer (PCa) from 2002 to 2012. Kaplan-Meier and multivariable Cox regression analyses were performed using a landmark starting at 6 mo of follow-up. In total, 75% patients had D’Amico intermediate- (48%) or high- (27%) risk PCa. Median follow-up was 5.6 yr. Median time to prostate-specific antigen (PSA) nadir was 3.3 mo, and 70 patients reached PSA <0.2 ng/ml postcryoablation. The 90-d high-grade (Clavien Grade IIIa) complication rate was 3%, with no rectal fistulas reported. Continence and potency rates were 96% and 11%, respectively. The 5-yr biochemical failure-free survival (PSA nadir + 2 ng/ml) was 81% overall and 89% for low-, 78% for intermediate-, and 80% for high-risk PCa (p = 0.46). The median follow-up was 5.6 and 5.1 yr for patients without biochemical failure and with biochemical failure, respectively. The 5-yr clinical recurrence-free survival was 83% overall and 94% for low-, 84% for intermediate-, and 69% for high-risk PCa (p = 0.046). Failure to reach PSA na...
Source: European Urology - Category: Urology & Nephrology Source Type: research