Hemigland Cryoablation for Localized Prostate Cancer: Outcomes at 5 Years
Posted: Monday, December 16, 2019
According to research published in The Journal of Urology, the 5-year treatment-free survival of patients with localized prostate cancer who underwent hemigland cryoablation was 85%, with higher rates in those with low-risk disease (95%) and lower rates in those with high-risk disease (78%). “Hemigland cryoablation of localized prostate cancer provides effective midterm oncologic outcomes with good continence and potency,” concluded Andre Luis Abreu, MD, of the University of Southern California, and colleagues.
The study included 160 consecutive cases of men with localized prostate cancer and a median age of 67 years who were treated with hemigland cryoablation (defined as hemigland ablation of the prostate lobe harboring the dominant, biopsy-proven prostate cancer). The baseline prostate-specific antigen (PSA) level among participants was 6.3 ng/mL, and the majority of patients (n = 131; 82%) had intermediate-risk (66%) or high-risk (16%) disease.
At a follow-up of 5 years, the clinically significant disease-free survival rate was 89%, and the treatment failure–free survival rate was 85%. The rate of biochemical failure–free survival was lower, at 62%. At 5 years out, no patient had metastatic disease.
Patients with a higher baseline PSA level were reliably found to be at an increased risk of treatment failure (P < .001), biochemical failure (P = .048), and disease recurrence and the need for radical treatment (P < .01). Patients with at least grade 3 disease were also found to be at increased risk of treatment failure (P = .04). A total of 97% of patients retained pad-free continence, and 73% of patients retained potency. No instances of rectal fistula or mortality were reported.
“Given the limitations of this study, hemigland cryoablation should be performed with caution and in carefully selected patients, especially in those with high-risk prostate cancer,” Dr. Abreu and colleagues concluded. “Additional data from prospective trials with large and multicenter cohorts are necessary to validate our reported findings.”
Disclosure: The study authors reported no conflicts of interest.