Mp25-16 Focal Cryotherapy for Localized Prostate Cancer: Initial Report From the International Focal Therapy Society (Fts) Registry

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-16 FOCAL CRYOTHERAPY FOR LOCALIZED PROSTATE CANCER: INITIAL REPORT FROM THE INTERNATIONAL FOCAL THERAPY SOCIETY (FTS) REGISTRY Ardeshir Rastinehad, Sriram Deivasigamani, Michael J. Schwartz, John F. Ward, Arvin George, Abhinav Sidana, Ezequiel Becher, Aaron E. Katz, Rafael Sanchez-Salas, and Thomas J. Polascik Ardeshir RastinehadArdeshir Rastinehad , Sriram DeivasigamaniSriram Deivasigamani , Michael J. SchwartzMichael J. Schwartz , John F. WardJohn F. Ward , Arvin GeorgeArvin George , Abhinav SidanaAbhinav Sidana , Ezequiel BecherEzequiel Becher , Aaron E. KatzAaron E. Katz , Rafael Sanchez-SalasRafael Sanchez-Salas , and Thomas J. PolascikThomas J. Polascik View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal cryotherapy was initially utilized to treat low-risk prostate cancer (PCa) as an alternative to active surveillance. The development of imaging and biopsy techniques resulted in the accurate localization of the tumor that allowed focal therapy to be considered in intermediate and carefully selected localized high-risk diseases. This study presents the first report of the oncological and functional outcomes of focal cryotherapy in patients with organ confined PCa, from our prospective, international multicenter Focal Therapy Society (FTS) registry. METHODS: An analysis of consecutive patients who underwent focal cryoablation with >6 months of follow-up between 2005-2023 was conducted. These patient details were prospectively recorded in the FTS registry from the 8 centers (7 US and one South American). The primary outcome was to determine the failure-free survival (FFS), defined as avoidance of salvage therapy including radical prostatectomy, radiation therapy, repeat ablation, systemic therapy, and metastasis/cancer-specific death. The secondary outcomes include cancer-specific survival (CSS), overall survival (OS), and metastasis-free survival (MFS) along with reporting the functional outcomes including urinary continence, defined as strictly no pad usage, and preserved erectile function (patient-reported, with/without pharmacologic intervention, defined as an erection sufficient for sexual intercourse of those patients who were initially potent IIEF 5>17) at 12 months. RESULTS: A total of 282 patients met the study inclusion criteria. The median follow-up was 24 months (interquartile range IQR 12-43). The median age was 72 years (IQR, 66-76) and the median preoperative PSA was 6.8 ng/ml (IQR, 5-9.35). A total of 217 (77%) patients and 45 (16%) patients had D'Amico intermediate- and high-risk disease. FFS was 74% (95% confidence interval CI 63-80%) at 5 years. The MFS, CSS and OS at 5 years was 97% (95% CI 89-99%), 99% (95% CI 92-99%), and 96% (95% CI 89-98%), respectively. Post-ablation biopsy was performed in 70% (198/282) of patients, showing a clinically significant in-field and out-field PCa recurrence rate of 11% and 18%. Of 212 patients with minimum of 1-year follow-up, 74% (77/104) of patients who were initially potent maintained erections sufficient for sexual intercourse and 98% (209/212) of patients are continent requiring no pad usage at 12-month follow-up. CONCLUSIONS: In this multicenter international study of focal cryoablation for organ-confined prostate cancer, mid-term results appeared to be promising with good oncological control and low rates of treatment-related functional outcomes decline. Further multicenter studies with a larger sample size are required to validate these findings. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e410 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Ardeshir Rastinehad More articles by this author Sriram Deivasigamani More articles by this author Michael J. Schwartz More articles by this author John F. Ward More articles by this author Arvin George More articles by this author Abhinav Sidana More articles by this author Ezequiel Becher More articles by this author Aaron E. Katz More articles by this author Rafael Sanchez-Salas More articles by this author Thomas J. Polascik More articles by this author Expand All Advertisement PDF downloadLoading ...