BERKELEY, CA (UroToday.com) - In the present study, we assess the outcomes of salvage cryotherapy for locally recurrent prostate cancer within the COLD (Cryo On-Line Data) registry, and, moreover, we evaluate the results of salvage cryotherapy stratified by pre-treatment prostate specific antigen (PSA) levels to determine which patients may be best suited for treatment.
The COLD registry was developed as a prospective, centrally-collected database among patients undergoing salvage cryoablation for locally recurrent prostate cancer following primary prostate radiotherapy with curative intent. Of the patients undergoing salvage cryotherapy (without neoadjuvant hormonal ablative therapy), complete medical records were available in 156 patients, with their mean follow-up being 3.8 years (0.9-12.7 years). The treatment outcomes of salvage cryotherapy were assessed using the Phoenix definition (nadir PSA + 2 ng/ml) of biochemical failure. Of our entire study population, the biochemical disease-free survival (bDFS) rates at 1, 2, and 3 years were 89.0%, 73.7%, and 66.7%, respectively. Stratification of our patients into 2 subgroups based on their pre-treatment total serum PSA values < 5 and ≥ 5 ng/ml, bDFS rates at 3 years for these two subgroups were 78.3 % and 52.9 %, respectively. A Kaplan Meier analysis of bDFS stratified by these same pre-treatment PSA values revealed that the subset of patients with a PSA ≥ 5 ng/ml had statistically significant poorer bDFS rates (P= 0.01).
In conclusion, salvage prostate cryotherapy is a potentially curative local salvage therapy. The importance of early referral when patients have a pre-treatment PSA < 5 ng/ml is essential to optimize treatment outcomes.
Written by:
Philippe E. Spiess, MD, MSc, FACS, FRCS(C) as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Associate Member
Department of Genitourinary Oncology
Moffitt Cancer Center 12902 Magnolia Drive
Tampa, FL 33612 USA
More Information about Beyond the Abstract