Pd39-04 MR Fusion Cryoablation: 5 Year Outcomes for Low and Intermediate Risk Patients

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II (PD39)1 May 2024PD39-04 MR FUSION CRYOABLATION: 5 YEAR OUTCOMES FOR LOW AND INTERMEDIATE RISK PATIENTS Giuseppe Maiolino, Michael Kattan, Farshad Shafizadeh, Edward L. Gheiler, Gloria Egui-Benatuil, Ariel M. Kaufman, and Fernando J. Bianco Giuseppe MaiolinoGiuseppe Maiolino , Michael KattanMichael Kattan , Farshad ShafizadehFarshad Shafizadeh , Edward L. GheilerEdward L. Gheiler , Gloria Egui-BenatuilGloria Egui-Benatuil , Ariel M. KaufmanAriel M. Kaufman , and Fernando J. BiancoFernando J. Bianco View All Author Informationhttps://doi.org/10.1097/01.JU.0001008924.16121.42.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Focal Therapy (FT) is a safe option for low and intermediate risk PCa patients. Three RCTs showed no significant difference between Active Surveillance (AS) and radical treatments for low-risk cases, with limited survival benefits. FT can reduce over-treatment and QoL side-effects. Image fusion techniques ensure accuracy of FT, as shown by a study on large patient group treated with primary MRI/US fusion guided cryotherapy (MRFC). METHODS: Our MRFC protocol was approved by the Ethical Committee registered at NCT02381990 - clinicaltrials.gov. It is a registry focused on treatment outcomes for cancer lesions using MRFC, with data recorded from PCa patients who underwent primary MRFC. We assessed FFP and survival metrics (Overall and Cancer-specific survival) at 5-years, defining FFP as conversion to whole gland treatment, hormonal suppression initiation, or metastasis development. Uni- and multivariate Cox Proportional-Hazards Model were used to identify independent predictive factors. The procedures were done in an office-setting with local anesthesia. RESULTS: The analysis involved 1,083 patients with a mean age of 70 years and a mean PSA level of 7.4 ng/ml. Lesions treated had PI-RADS scores of 1-2, 3, 4 and 5, representing 6%, 35%, 35% and 24% respectively. The ISUP breakdown at biopsy was ISUP 1 in 46% of patients, ISUP 2 in 38% and ISUP 3 in 16%. The PSA density median was 0.13 0.09,0.2. At the five-year mark, FFP, OS, and CCS rates were 86%, 91% and 100%. A total of 43 men died from other causes and 252 patients were still at risk. The Figure 1 shows the differences between ISUP groups. The results of the multivariate analysis indicate that the PSA density is an independent predictive factor of FFP, with an HR of 1.02 and a p-value of 0.008. CONCLUSIONS: The office's MRFC has revealed a safe oncological control at 3, 5, and 7 years, where more than 250 high-risk patients after the 5-year period. The primary risk differentiator determined was PSAD. Noteworthy differences in outcomes have not been observed between tumors treated with ISUP 1 and 2. Download PPT Source of Funding: Urological Research Network Foundation © 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 Giuseppe Maiolino More articles by this author Michael Kattan More articles by this author Farshad Shafizadeh More articles by this author Edward L. Gheiler More articles by this author Gloria Egui-Benatuil More articles by this author Ariel M. Kaufman More articles by this author Fernando J. Bianco More articles by this author Expand All Advertisement PDF downloadLoading ...