Treatment of localized prostate cancer with whole gland cryoablation (WGC) resulted in high rates of biochemical recurrence-free survival (BRFS) and “excellent” functional outcomes, researchers reported in Cancer.
“The role of primary WGC as an alternative to radiation therapy or radical prostatectomy for definitive treatment of prostate cancer remains uncertain,” the researchers wrote.
The aim of their study was to evaluate long-term outcomes among patients who underwent WGC for localized prostate cancer.
This retrospective study included data from 260 men who received WGC at a single tertiary referral center between 2002 and 2019. At baseline, the median age of the cohort was 64 years; 70% of patients were White, 26.5% were Black, and 3.5% were identified as “other” race. The median prostate-specific antigen level was 6.1 ng/mL.
The primary outcome was BRFS, and secondary endpoints included failure-free survival, metastasis-free survival, and adverse events. The median follow-up was 107 months.
No prostate cancer-related deaths were reported, and BRFS ranged from 97% at year 1 to 87% at year 9. A total of 13.5% of patients experienced a biochemical recurrence.
Treatment failure occurred in 77 patients, and rates of failure-free survival ranged from 98% at year 1 to 71% at year 9.
Few patients (3.8%) developed metastatic disease, and metastasis-free survival ranged from 100% at year 1 to 97% at year 7.
Functional outcomes after WGC were deemed excellent, with stress urinary incontinence occurring in 2% of patients. There was no change in the median International Index of Erectile Function score from before to after WGC. There were no reports of fistula, and grade 2 or higher adverse events were reported in 2.3% of patients.
“WGC of the prostate can achieve excellent oncological and functional outcomes in men with localized Pca [prostate cancer] at the 10-year mark,” the researchers wrote. “Primary WGC may be a good option for men who desire to preserve urinary continence and have an excellent oncologic outcome.”
Tan WP, Kotamarti S, Chen E, et al. Oncological and functional outcomes of men undergoing primary whole gland cryoablation of the prostate: a 20-year experience. Cancer. Published online September 15, 2022. doi:10.1002/cncr.34458