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

Research output: Contribution to journalArticle

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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

Fingerprint

Cryosurgery
Radio
Disease-Free Survival
Prostatic Neoplasms
Prostate-Specific Antigen
Survival
Neoplasm Metastasis
Morbidity
Databases
Survival Analysis
Regression Analysis
Biopsy
Therapeutics

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

Long-Term Oncologic Outcomes of Salvage Cryoablation for Radio-Recurrent Prostate Cancer. / Siddiqui, Khurram M.; Billia, Michele; Al-Zahrani, Ali; Williams, Andrew; Goodman, Christopher; Arifin, Andrew; Violette, Philippe; Bauman, Glenn; Chin, Joseph L.

In: Journal of Urology, Vol. 196, No. 4, 01.10.2016, p. 1105-1111.

Research output: Contribution to journalArticle

Siddiqui, KM, Billia, M, Al-Zahrani, A, Williams, A, Goodman, C, Arifin, A, Violette, P, Bauman, G & Chin, JL 2016, 'Long-Term Oncologic Outcomes of Salvage Cryoablation for Radio-Recurrent Prostate Cancer', Journal of Urology, vol. 196, no. 4, pp. 1105-1111. https://doi.org/10.1016/j.juro.2016.04.080
Siddiqui, Khurram M. ; Billia, Michele ; Al-Zahrani, Ali ; Williams, Andrew ; Goodman, Christopher ; Arifin, Andrew ; Violette, Philippe ; Bauman, Glenn ; Chin, Joseph L. / Long-Term Oncologic Outcomes of Salvage Cryoablation for Radio-Recurrent Prostate Cancer. In: Journal of Urology. 2016 ; Vol. 196, No. 4. pp. 1105-1111.
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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.",
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AU - Williams, Andrew

AU - Goodman, Christopher

AU - Arifin, Andrew

AU - Violette, Philippe

AU - Bauman, Glenn

AU - Chin, Joseph L.

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N2 - 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.

AB - 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.

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KW - neoplasm recurrence, local

KW - prostatic neoplasms

KW - radiotherapy

KW - salvage therapy

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