Pd39-11 Redo Focal Therapy for Recurrent Localized Prostate Cancer: A Single Institution Experience

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (PD39)1 May 2024PD39-11 REDO FOCAL THERAPY FOR RECURRENT LOCALIZED PROSTATE CANCER: A SINGLE INSTITUTION EXPERIENCE Daniele Cignoli, Luigi Candela, Andrea Rodriguez-Serrano, David Lopez, Armando Stabile, Andrea Salonia, Alberto Briganti, Francesco Montorsi, Camille Lanz, Eric Barret, Annick Mombet, Petr Macek, Xavier Cathelineau, and Lara Rodriguez-Sanchez Daniele CignoliDaniele Cignoli , Luigi CandelaLuigi Candela , Andrea Rodriguez-SerranoAndrea Rodriguez-Serrano , David LopezDavid Lopez , Armando StabileArmando Stabile , Andrea SaloniaAndrea Salonia , Alberto BrigantiAlberto Briganti , Francesco MontorsiFrancesco Montorsi , Camille LanzCamille Lanz , Eric BarretEric Barret , Annick MombetAnnick Mombet , Petr MacekPetr Macek , Xavier CathelineauXavier Cathelineau , and Lara Rodriguez-SanchezLara Rodriguez-Sanchez View All Author Informationhttps://doi.org/10.1097/01.JU.0001008924.16121.42.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal therapy FT for localized Prostate Cancer PCa is associated with a not negligible rate of recurrence after treatment. With this study, we aimed to assess the safety and efficacy of redoFT rFT. METHODS: 48 patients treated with rFT (HIFU or cryotherapy CRYO) because of recurrence after a previous FT for low- and intermediate-risk PCa at one European high-volume center between 2009 and 2018, were retrospectively analyzed. The primary outcome of the study was to assess failure free-survival (FFS, defined as post rFT positive biopsy within ISUP≥2, whole gland or systemic salvage treatment, PCa metastasis and/or PCa specific death) and radical treatment free-survival (TFS, radical prostatectomy RP, radiotherapy RT, and/or hormone therapy HT after rFT). Secondly, Multivariable Cox regression analysis MVA was used to predict the effect of %∆PSA after rFT (defined as the ratio between PSA nadir and pre-rFT PSA) on the outcomes. Covariates were age, pre-rFT PSA and PSA density PSAd, ISUP, mm of positive biopsy cores and treatment type. RESULTS: All 48 patients included in the analyses underwent a first FT (67% HIFU and 33% CRYO) for low- and intermediate-risk PCa (63% ISUP1 and 37% ISUP2-3) and a rFT (71% HIFU and 29% CRYO) because of recurrence. Median %∆PSA, after rFT, was 47%(IQR: 22-63). Median FU, after rFT, was 54mos (IQR:32-70). Treatment failure rate after rFT was 50% (24pts). Among recurrences, 58% (14pts) were infield to rFT location, while outfield in 42% (10pts). 58% were ISUP 2, 38% ISUP 3 and 4% ISUP 4. Median FFS was 63mos (95%CI 27-NA). Because of recurrence, 23pts (48%) underwent whole gland treatment, namely RP(8%), RT(23%), HT(4%) or a combination(13%). Median TFS was 41mos (95%CI 30-NA). PCa metastasis occurred in 2 patients and no PCa specific death were registered. At MVA, %∆PSA after rFT was an independent predictor of both FFS (HR: 0.25, 95%CI: 0.08-0.75, p=0.01) and TFS (HR: 0.20, 95%CI: 0.06-0.65, p=0.007). Overall, 9pts (19%) experienced early complications after rFT, 8(17%) were Clavien 1 and 1(2%) Clavien 2. CONCLUSIONS: With a low rate of complications, rFT seems to be a good option in case of recurrence after a previous FT as approximately half of patients who experience PCa recurrence after their initial FT treatment may be able to postpone or even avoid the need for more invasive radical therapies. Multicenter studies are warranted. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e817 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Daniele Cignoli More articles by this author Luigi Candela More articles by this author Andrea Rodriguez-Serrano More articles by this author David Lopez More articles by this author Armando Stabile More articles by this author Andrea Salonia More articles by this author Alberto Briganti More articles by this author Francesco Montorsi More articles by this author Camille Lanz More articles by this author Eric Barret More articles by this author Annick Mombet More articles by this author Petr Macek More articles by this author Xavier Cathelineau More articles by this author Lara Rodriguez-Sanchez More articles by this author Expand All Advertisement PDF downloadLoading ...