Mp25-06 Long Term Oncological and Functional Outcomes of Focal Cryoablation of Localized Prostate Cancer With a Median Follow-Up of 7 Years: A Single Institution Experience

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy I (MP25)1 May 2024MP25-06 LONG TERM ONCOLOGICAL AND FUNCTIONAL OUTCOMES OF FOCAL CRYOABLATION OF LOCALIZED PROSTATE CANCER WITH A MEDIAN FOLLOW-UP OF 7 YEARS: A SINGLE INSTITUTION EXPERIENCE Sriram Deivasigamani, Mahdi Mottaghi, Eric S. Adams, Srinath Kotamarti, and Thomas J. Polascik Sriram DeivasigamaniSriram Deivasigamani , Mahdi MottaghiMahdi Mottaghi , Eric S. AdamsEric S. Adams , Srinath KotamartiSrinath Kotamarti , and Thomas J. PolascikThomas J. Polascik View All Author Informationhttps://doi.org/10.1097/01.JU.0001008692.26556.39.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Traditional radical approaches to clinically localized prostate cancer (PCa) have been largely oncologically effective but associated with complications and decline in functional outcomes, arguably making them unsuitable in all cases for treatment. This necessitates an alternative option, focal ablation, which has good oncological control while reducing treatment-related functional detriments. Although mid-term oncological and functional outcomes of focal ablation were proven, the long-term outcomes were lacking. We sought to report the long-term oncological and functional outcomes of focal cryoablation for non-metastatic PCa treatment. METHODS: An IRB-approved retrospective review of a prospectively maintained database of patients who have undergone focal ablation of the prostate at Duke between 2005-2020 with a minimum follow-up of 3 yrs. The primary outcome was to determine the 5-year and 10-year failure-free survival (FFS), defined as the avoidance of salvage therapy including radical prostatectomy, radiation therapy, repeat ablation, systemic therapy, and metastasis/cancer-specific death, cancer-specific survival (CSS), overall survival (OS) and metastasis-free survival (MFS). The secondary outcome was to study the functional outcomes using the International Prostate Symptom Score (IPSS) 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: 70 patients with complete data met the study inclusion criteria. The median follow-up was 86 mo (interquartile range IQR 46-113). The median age was 75 yrs (69-80) and the median preoperative PSA was 6.5 ng/ml (4.7-9.34). Of 70 patients, 43 (61%) and 21 (30%) patients had D'Amico intermediate- and high-risk disease. FFS was 84% (95% confidence interval CI 72-91%) at 5 yrs and 58% (95% CI 41-72%) at 10 yrs, respectively. The MFS, CSS, and OS at 10 yr were 94% (95% CI 85-98%), 98% (95% CI 89-99%), and 88% (95% CI 75-95%), respectively. About 73% (32/44) of patients who were initially potent were able to maintain erections sufficient for sexual intercourse and 97% (68/70) of patients are continent requiring no pad usage at 12-month follow-up. CONCLUSIONS: Primary focal cryoablation has good long-term oncological control in men with localized PCa. Focal ablation may be a better option for men who desire to preserve good functional outcomes and thus quality of life. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e405 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Sriram Deivasigamani More articles by this author Mahdi Mottaghi More articles by this author Eric S. Adams More articles by this author Srinath Kotamarti More articles by this author Thomas J. Polascik More articles by this author Expand All Advertisement PDF downloadLoading ...