Purpose: In Taiwan and other Asian countries, the role of focal cryoablation for prostate cancer remains underexplored. While cryoablation is recognized as a minimally invasive treatment, data on its long-term outcomes, especially in patients with higher-risk or locally advanced disease, have been scarce. Materials and methods: We reviewed 34 men treated with primary focal cryoablation at our institution between 2008 and 2020. Clinical characteristics, prostate-specific antigen kinetics, oncological outcomes, functional results, and complications were analyzed. Potency and continence were assessed by patient report and validated questionnaires. Results: After a median follow-up of more than 11 years, biochemical recurrence (BCR) was observed in 21 patients (61.7%). Five-year BCR-free survival differed markedly by risk groups: 77.8% in low-risk disease, 48.5% in intermediate-risk disease, and 0% in high-risk disease. Despite the high BCR rates, 10-year cancer-specific and overall survival were excellent (100%), largely due to timely salvage therapies. Functional outcomes were encouraging. Nearly 80% of men who were potent before treatment retained erectile function, and continence was preserved in all patients. Complications were minor and manageable. Conclusion: Our long-term experience suggests that focal cryoablation can maintain good urinary and sexual function while providing reasonable cancer control in selected patients with low- to intermediate-risk disease. However, the unsatisfactory outcomes in high-risk patients highlight the need for careful selection and integration with other treatment strategies.
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Hsieh et al. (2026) studied this question.
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