Long-Term Oncologic Outcomes of Salvage Cryoablation for Radio-Recurrent Prostate Cancer

Khurram M. Siddiqui, Michele Billia, Ali Al-Zahrani, Andrew Williams, Christopher Goodman, Andrew Arifin, Philippe Violette, Glenn Bauman, Joseph L. Chin

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4 Citations (Scopus)

Abstract

Purpose Management of localized radio-recurrent prostate cancer is not standardized, partly due to the absence of long-term data on oncologic control and the toxicity of various treatment modalities. We analyzed the long-term oncologic outcomes and morbidity of salvage cryoablation for radio-recurrent prostate cancer. Materials and Methods Patients undergoing salvage cryoablation for biopsy proven, localized radio-recurrent prostate cancer from 1995 to 2004 were prospectively accrued. Preoperative characteristics, perioperative morbidity and postoperative data were reviewed from a prospectively maintained database or via telephonic contact with the patient. The primary outcome was overall survival. Secondary outcomes were metastasis-free and biochemical disease-free survival. The Kaplan-Meier method was used for survival analysis and multivariable Cox regression analysis was performed. Results Of 187 patients 157 (84%) had records available for followup. Mean ± SD age was 69.4 ± 5.8 years and mean presalvage prostate specific antigen was 6.6 ± 5.7 ng/ml. Median followup was 117 months (IQR 55–154). Five and 10-year overall survival was 93% and 76%, respectively. Biochemical disease-free survival at 10 and 15 years was 35% and 22.6% whereas metastasis-free survival at 10 and 15 years was 86% and 71%, respectively. On multivariable analysis precryoablation and nadir prostate specific antigen values were significant predictors of metastasis-free and biochemical disease-free survival. Age at salvage cryoablation (p = 0.008) and nadir prostate specific antigen (p = 0.015) were significant predictors of overall survival. There were 157 Clavien-Dindo grade 1-2 and 22 grade 3 complications. Conclusions A single center, long-term experience documented by a prospectively maintained database shows that cryoablation is a viable salvage option for radio-recurrent prostate cancer as it provides durable biochemical disease-free survival with acceptable morbidity.

Original languageEnglish
Pages (from-to)1105-1111
Number of pages7
JournalJournal of Urology
Volume196
Issue number4
DOIs
Publication statusPublished - Oct 1 2016

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Keywords

  • cryosurgery
  • neoplasm recurrence, local
  • prostatic neoplasms
  • radiotherapy
  • salvage therapy

ASJC Scopus subject areas

  • Urology

Cite this

Siddiqui, K. M., Billia, M., Al-Zahrani, A., Williams, A., Goodman, C., Arifin, A., ... Chin, J. L. (2016). Long-Term Oncologic Outcomes of Salvage Cryoablation for Radio-Recurrent Prostate Cancer. Journal of Urology, 196(4), 1105-1111. https://doi.org/10.1016/j.juro.2016.04.080