Intermediate-term oncologic and functional outcomes after salvage cryoablation for localized, biopsy-proven recurrent prostate cancer following primary external beam radiotherapy versus primary cryotherapy
The Journal of Urology(2023)
Abstract
You have accessJournal of UrologyCME1 Apr 2023MP73-18 INTERMEDIATE-TERM ONCOLOGIC AND FUNCTIONAL OUTCOMES AFTER SALVAGE CRYOABLATION FOR LOCALIZED, BIOPSY-PROVEN RECURRENT PROSTATE CANCER FOLLOWING PRIMARY EXTERNAL BEAM RADIOTHERAPY VERSUS PRIMARY CRYOTHERAPY Scott P. Campbell, Rohith Arcot, Sriram Deivasigamani, Eric S. Adams, Hazem Orabi, Ahmed Elshafei, Wei Phin Tan, Leah Davis, Yuan Wu, Andrew Chang, J Stephen Jones, and Thomas J Polascik Scott P. CampbellScott P. Campbell More articles by this author , Rohith ArcotRohith Arcot More articles by this author , Sriram DeivasigamaniSriram Deivasigamani More articles by this author , Eric S. AdamsEric S. Adams More articles by this author , Hazem OrabiHazem Orabi More articles by this author , Ahmed ElshafeiAhmed Elshafei More articles by this author , Wei Phin TanWei Phin Tan More articles by this author , Leah DavisLeah Davis More articles by this author , Yuan WuYuan Wu More articles by this author , Andrew ChangAndrew Chang More articles by this author , J Stephen JonesJ Stephen Jones More articles by this author , and Thomas J PolascikThomas J Polascik More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Local prostate cancer recurrence following treatment with external beam radiation (XRT) or cryotherapy may be treated with salvage cryotherapy (SCT), but little is known about how the primary treatment modality influences SCT outcomes. We compare the oncologic and functional outcomes of patients who received whole- or partial-gland SCT after primary XRT (XRT-SCT) or primary cryoablation (CRYO-SCT). METHODS: The Duke Prostate Cancer database and the Cryo On-Line Data (COLD) registry were used to analyze data on XRT-SCT and CRYO-SCT patients. Propensity score matching was performed with variables selected that had an impact on oncologic outcomes. The primary outcome was biochemical progression-free survival (BPFS), as defined by the Phoenix criteria. Urinary incontinence, rectourethral fistula formation, and erectile dysfunction were secondary outcomes. The Kaplan-Meier log-rank test, as well as Cox proportional hazards modelling, were used to compare BPFS rates and identify factors influencing BPFS. To identify factors that can predict biochemical recurrence (BCR), a multivariate logistic regression analysis was performed. RESULTS: 419 XRT-SCT and 63 CRYO-SCT patients met the inclusion criteria, which was reduced to 63 patients in each cohort after propensity matching. On the 2- and 5-year Kaplan-Meier log-rank tests, no difference in BPFS was found. In multivariate analysis, the CRYO-SCT group had similar rates of BCR as compared to XRT-SCT (OR=1.63; p=0.2). For both groups, higher (OR=36.38; p=0.03) and intermediate (OR 8.26; p=0.01) D’Amico risk category was associated with higher rates of BCR relative to low-risk. There were no significant differences in post-salvage changes to functional outcomes. CONCLUSIONS: Oncologic and functional outcomes following salvage cryoablation appear to be similar for well-matched patients who underwent XRT-SCT or CRYO-SCT. Risk category was an important predictor of oncologic outcomes, suggesting the importance of close follow-up after primary treatment to promote early salvage treatment. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1042 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Scott P. Campbell More articles by this author Rohith Arcot More articles by this author Sriram Deivasigamani More articles by this author Eric S. Adams More articles by this author Hazem Orabi More articles by this author Ahmed Elshafei More articles by this author Wei Phin Tan More articles by this author Leah Davis More articles by this author Yuan Wu More articles by this author Andrew Chang More articles by this author J Stephen Jones More articles by this author Thomas J Polascik More articles by this author Expand All Advertisement PDF downloadLoading ...
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Key words
prostate cancer,primary external beam radiotherapy,salvage cryoablation,primary cryotherapy,intermediate-term,biopsy-proven
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