Comparative morbidity of ablative energy-based salvage treatments for radio-recurrent prostate cancer

Khurram M. Siddiqui, Michele Billia, Andrew Williams, A. Alzahrani, Joseph L. Chin

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Abstract

Introduction: We compared the morbidity of whole gland salvage ablation using cryotherapy (CRYO) and high-intensity focused ultrasound (HIFU) for radio recurrent prostate cancer at a single centre over a 17-year period. Methods: Patients were divided in 3 cohorts. Group 1 included the first 65 patients treated with CRYO (1995–1998); Group 2 included the last 65 patients treated with CRYO (2002–2004), and Group 3 included 65 patients treated with HIFU (2006–2011). We analyzed the complications reported within at least 90 days of treatment or up to the last follow-up. Results: We tallied Clavien grade complications. For Groups 1, 2 and 3, we recorded the following Clavien I-II complications: 78, 49 and 13, respectively. For Clavien grade IIIa, 2, 5 and 4 for Groups 1, 2 and 3, respectively. For Clavien grade IIIb, 8, 2 and 3 for Groups 1, 2 and 3, respectively. Clavien grade II complications were statistically higher in Group 1 versus Group 2 (p = 0.005) and in Group 2 versus Group 3 (p = 0.0001). The rate of mild-moderate incontinence was significantly higher in the CRYO group compared to the HIFU cohort (p ≤ 0.05). The rate of urinary retention was significantly higher in Group 2 compared to Group 3 (p = 0.0005). The rates of severe incontinence (range: 1.5%–5%), need for surgical intervention (uniform at 1.5%), and recto-urethral fistulae (range: 1.5%–3%) were not statistically different. Conclusions: CRYO was associated with higher overall morbidity. The morbidity during the early experience with HIFU was lower than both subgroups of CRYO. This may reflect the advancement of technology or cumulative learning experience.

Original languageEnglish
Pages (from-to)325-329
Number of pages5
JournalJournal of the Canadian Urological Association
Volume9
Issue number9-10 October
DOIs
Publication statusPublished - Oct 13 2015

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Salvage Therapy
Cryotherapy
Radio
Prostatic Neoplasms
Morbidity
Urinary Retention
Fistula
Learning
Technology

ASJC Scopus subject areas

  • Oncology
  • Urology

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Comparative morbidity of ablative energy-based salvage treatments for radio-recurrent prostate cancer. / Siddiqui, Khurram M.; Billia, Michele; Williams, Andrew; Alzahrani, A.; Chin, Joseph L.

In: Journal of the Canadian Urological Association, Vol. 9, No. 9-10 October, 13.10.2015, p. 325-329.

Research output: Contribution to journalArticle

Siddiqui, Khurram M. ; Billia, Michele ; Williams, Andrew ; Alzahrani, A. ; Chin, Joseph L. / Comparative morbidity of ablative energy-based salvage treatments for radio-recurrent prostate cancer. In: Journal of the Canadian Urological Association. 2015 ; Vol. 9, No. 9-10 October. pp. 325-329.
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abstract = "Introduction: We compared the morbidity of whole gland salvage ablation using cryotherapy (CRYO) and high-intensity focused ultrasound (HIFU) for radio recurrent prostate cancer at a single centre over a 17-year period. Methods: Patients were divided in 3 cohorts. Group 1 included the first 65 patients treated with CRYO (1995–1998); Group 2 included the last 65 patients treated with CRYO (2002–2004), and Group 3 included 65 patients treated with HIFU (2006–2011). We analyzed the complications reported within at least 90 days of treatment or up to the last follow-up. Results: We tallied Clavien grade complications. For Groups 1, 2 and 3, we recorded the following Clavien I-II complications: 78, 49 and 13, respectively. For Clavien grade IIIa, 2, 5 and 4 for Groups 1, 2 and 3, respectively. For Clavien grade IIIb, 8, 2 and 3 for Groups 1, 2 and 3, respectively. Clavien grade II complications were statistically higher in Group 1 versus Group 2 (p = 0.005) and in Group 2 versus Group 3 (p = 0.0001). The rate of mild-moderate incontinence was significantly higher in the CRYO group compared to the HIFU cohort (p ≤ 0.05). The rate of urinary retention was significantly higher in Group 2 compared to Group 3 (p = 0.0005). The rates of severe incontinence (range: 1.5{\%}–5{\%}), need for surgical intervention (uniform at 1.5{\%}), and recto-urethral fistulae (range: 1.5{\%}–3{\%}) were not statistically different. Conclusions: CRYO was associated with higher overall morbidity. The morbidity during the early experience with HIFU was lower than both subgroups of CRYO. This may reflect the advancement of technology or cumulative learning experience.",
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