Salvage Cryotherapy For Recurrent Prostate Cancer After Radiation Failure. The UK Experience

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Clinical Trials / Drug Trials
Article Date: 02 Jun 2008 - 4:00 PDT

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ORLANDO, FL (UroToday.com) - A group of researchers from the UK report on the largest UK experience of salvage cryotherapy for recurrent prostate cancer after radiation failure, evaluating the biochemical outcome, complications and management and quality of life. They reported on 100 patients who underwent salvage targeted cryoablation of the prostate (TCAP) between 2000 and 2005 for recurrent prostate cancer after radiotherapy. The mean follow-up was 33.5 months. All patients had biopsy proven recurrent prostate cancer. Biochemical recurrence-free survival (BRFS) was defined using PSA level <0.5ng/ml and the ASTRO definition of biochemical failure. Patients were stratified into 3 risk groups; high-risk (n=68), intermediate-risk (n=20) and low-risk (n=12).

They report no operative or cancer related deaths. The 5-year actuarial BRFS was 73%, 45% and 11% for the low, intermediate and high-risk groups respectively. Complications included incontinence (13%), erectile dysfunction (86%), lower urinary tract symptoms (16%), prolonged perineal pain (4%), urinary retention (2%), and rectourethral fistula (1%).

This series suggests that TCAP is safe, well tolerated, and an effective option for salvage treatment of prostate cancer. It is associated with low morbidity rate (except for erectile dysfunction) and for patients who failed their radiotherapy it offers additional hope of cure. High-risk patient showed the least favorable outcome hence, patient selection is essential prior to the treatment. Further research into long term survival and quality of life is recommended by the presenters.

Presented by Mohamed Ismail, MD, Marcia Hicks, MD, Shwan Ahmed, MD, and John Davies, MD at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor Christopher P. Evans, MD, FACS

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