Pd39-05 5-Year Oncologic Outcomes Following Primary Partial Gland Cryo-Ablation (Ppgca)

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (PD39)1 May 2024PD39-05 5-YEAR ONCOLOGIC OUTCOMES FOLLOWING PRIMARY PARTIAL GLAND CRYO-ABLATION (PPGCA) Herbert Lepor, Eli Rapoport, Majlinda Tafa, Rozalba Gogaj, Jesse Persily, Hunter Hernandez, and James Wysock Herbert LeporHerbert Lepor , Eli RapoportEli Rapoport , Majlinda TafaMajlinda Tafa , Rozalba GogajRozalba Gogaj , Jesse PersilyJesse Persily , Hunter HernandezHunter Hernandez , and James WysockJames Wysock View All Author Informationhttps://doi.org/10.1097/01.JU.0001008924.16121.42.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: There is increasing interest in focal therapy (FT) for treating focal intermediate risk prostate cancer (IRPCa). The objective of this prospective study is to assess 5-year oncologic outcomes in men with IRPCa following PPGCA. METHODS: Between 5/2017 and 10/2023, 442 men undergoing PPGCA were enrolled in a prospective study capturing oncologic and functional outcomes. Of these men, 298 had MRI concordant IRPCa with no out of field Gleason Grade Group (GGG)>1, no gross extracapsular extension or extreme apical disease on pre-treatment mpMRI. PSA was monitored every 6 months, and mpMRI at 6-12, 24, 42 and 60 months. Protocol biopsy at 6-12 months and 24 months were discontinued due to low rates of clinically significant prostate cancer (csPCa) defined as any Gleason pattern 4 disease. Treatment failure was defined as prostate cancer specific mortality, identification of metastatic disease, and undergoing whole gland (WG) or systemic treatment. RESULTS: 57 men had >5 years of follow-up data (Table 1) with a mean of 9.9, 3.6, and 2.2 surveillance PSA tests, MRIs, and prostate biopsies, respectively; none were lost to follow-up. csPCa was found in 19 men. At 5-years, rates of freedom-from-recurrence of in-field, out-of-field and overall csPCa were 88% (95% CI: 78-99), 75% (95% CI: 62-91), and 71% (95% CI: 57-87), respectively (Figure 1). The proportion with freedom-from-failure (FFF) at 5 years was 88% (95% CI: 79-97). None died from prostate cancer, 1 developed metastasis and 7 underwent WGT (1 radical prostatectomy and 6 radiation therapy). Overall, 88% underwent a protocol mpMRI at 5 years. The 16 csPCa recurrences were in field, out of field and both in and out of field in 2, 10 and 4, respectively, and were managed with androgen deprivation, WGT, salvage cryo-ablation or AS in 1, 7, 5, and 3 patients, respectively. CONCLUSIONS: A major strength of the present study is our 100% 5-year follow-up for FFF and high compliance rate with a rigorous prospective protocol for identifying recurrent csPCa. 5-year FFF was extremely high despite our very aggressive surveillance protocol. Download PPT Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e814 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Herbert Lepor More articles by this author Eli Rapoport More articles by this author Majlinda Tafa More articles by this author Rozalba Gogaj More articles by this author Jesse Persily More articles by this author Hunter Hernandez More articles by this author James Wysock More articles by this author Expand All Advertisement PDF downloadLoading ...