BERKELEY, CA (UroToday.com) - Salvage prostate cryotherapy is a potentially curative treatment for locally recurrent prostate cancer. In the present study, we strived to elucidate prognostic variables predicting the subsequent risk of biochemical-free survival (BFS) following salvage cryotherapy using the Phoenix definition.
A total of 132 patients underwent prostate whole gland salvage cryotherapy with: (1) curative intent, (2) in the absence of neoadjuvant/adjuvant hormonal ablative therapy, and (3) with extended post-salvage PSA follow-up data. At a mean follow-up of 4.3 years (0.9-12.7 years), the median post-cryotherapy nadir PSA achieved was 0.17 ng/ml (0-33.9 ng/ml).
On multivariate analysis, predictors of BFS were nadir PSA post-cryotherapy and pre-salvage biopsy Gleason score (P < 0.0001 and 0.0086, respectively). Risk stratification groups (good, intermediate, and poor) were developed based on the presence of 0, 1, or 2 adverse risk factors defined as either a nadir PSA > 2.5 ng/ml or biopsy Gleason score ≥ 7, with the Kaplan Meier BFS curves of these risk groups being statistically different (P = 0.02 and < 0.0001, respectively).
In summary, the post-salvage nadir PSA and pre-salvage biopsy Gleason score are important predictors of outcome in this patient cohort. Good-, intermediate-, and poor-risk groups have been developed based on these parameters and ultimately define patients best suited for prostate salvage cryotherapy with curative intent.
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.
Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Office 12538, Tampa, FL 33612, USA
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