Pd29-10 Office-Based Mri Fusion Cryoablation: Impact on Pca Treated Natural History by Recursive Partition Analysis

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD29)1 May 2024PD29-10 OFFICE-BASED MRI FUSION CRYOABLATION: IMPACT ON PCA TREATED NATURAL HISTORY BY RECURSIVE PARTITION ANALYSIS Fernando J. Bianco, Giuseppe Maiolino, Edward L. Gheiler, Ariel M. Kaufman, Juan I. Martinez-Salamanca, Farshad Shafizadeh, Gloria Egui-Benatuil, and Michael Kattan Fernando J. BiancoFernando J. Bianco , Giuseppe MaiolinoGiuseppe Maiolino , Edward L. GheilerEdward L. Gheiler , Ariel M. KaufmanAriel M. Kaufman , Juan I. Martinez-SalamancaJuan I. Martinez-Salamanca , Farshad ShafizadehFarshad Shafizadeh , Gloria Egui-BenatuilGloria Egui-Benatuil , and Michael KattanMichael Kattan View All Author Informationhttps://doi.org/10.1097/01.JU.0001008736.23117.7f.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Randomized trials comparing radical treatments to Active Surveillance (AS) for prostate cancer showed no or minimal survival benefits, highlighting the need for alternative, safe, and personalized approaches. MR Fusion Cryoablation (MRFC) can minimize over-treatment and improve quality of life by reducing side effects. Image fusion techniques with real-time ablation monitoring enhance precision in Ablative therapies (AT). We present results from a study of men who underwent MRFC and identify factors to consider when choosing this option to manage prostate cancer. METHODS: Our Ethical Committee approved the MRFC protocol, which started 10 years ago and registered as NCT02381990 on clinicaltrials.gov. The registry focuses on treatment outcomes for PCa lesions using AT. We examined a consecutive cohort of men who received primary MRFC performed in the office using local anesthesia by a Urologist. Our evaluation included assessing Freedom from Progression (FFP) and survival metrics (Overall and Cancer-specific survival). Progression (P), a treated natural history event, was defined as conversion to WGM-surgery, radiation, or complete prostate ablation- hormonal suppression initiation, or metastasis development. We utilized Uni- and multivariate Cox Proportional-Hazards Model and Competing-Risk analysis to identify independent predictive factors. Additionally, a cross-validated recursive partitioning tree identified predictive levels based on relevant preoperative factors against the primary outcome: FFP. RESULTS: In MRFC, 1,168 completed the procedure, which took a median of 53mins (IQR: 47-60). A figure 1 shows preop characteristics & analyses of P versus death by other causes (DOC); from year 1-9, individuals at risk is shown. The Cross validated RCT showed the prediction of progression based on significant factors: PSAD; MRI prostate volume(preMRIPV). After five years, 87% of individuals were free from progression, and 8% DOC. CONCLUSIONS: Office-based MRFC is showing a noteworthy impact on the natural progression of prostate cancer. However, it is essential to verify these results by conducting a comprehensive assessment of randomized controlled trials. Download PPT Source of Funding: Urologic Research Network Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e622 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Fernando J. Bianco More articles by this author Giuseppe Maiolino More articles by this author Edward L. Gheiler More articles by this author Ariel M. Kaufman More articles by this author Juan I. Martinez-Salamanca More articles by this author Farshad Shafizadeh More articles by this author Gloria Egui-Benatuil More articles by this author Michael Kattan More articles by this author Expand All Advertisement PDF downloadLoading ...