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Focal cryoablation for unilateral low-intermediate-risk prostate cancer: 63-month mean follow-up results of 41 patients

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Abstract

Objective

To report (1) intermediate-term oncologic and functional outcomes of primary focal cryoablation (FC) in selected patients with clinically unilateral, low-intermediate-risk prostate cancer, and investigate (2) the impact of patient selection criteria at predicting outcomes after FC.

Materials and methods

Forty-one patients with unilateral prostate cancer were treated with FC. Patients were stratified using the 2007 Task Force Focal Prostate Cancer Patient selection criteria (Task Force criteria). Posttherapy follow-up included questionnaires, PSA measurement, and TRUS-guided biopsies.

Results

Complete follow-up was available in 40 patients (median follow-up 63 months; range 12–92 months). Compared to precryotherapy PSA level (mean 7.1 ng/ml), postcryotherapy PSA level (mean 1.8 ng/ml) dropped by 75 % at 3 months (P < 0.0001) and this decline persisted throughout the follow-up period, with no significant difference seen across patient selection criteria (P = 0.859). The treatment failure rate was 10 % (4/40) with no significant difference seen across patient selection criteria (P = 0.832). Of 32 patients undergoing postcryotherapy biopsy, 7 (22 %) had positive biopsies (2 ipsilateral lobes, 5 contralateral lobes). Patients of Task Force criteria group were less likely to have positive biopsy in contralateral lobe than focal control group (P = 0.032). Complete continence (no pads) and potency sufficient for intercourse were documented in 97.6 and 76.9 % of patients, respectively.

Conclusions

The intermediate-term oncologic efficacy of primary FC in selected patients with clinically unilateral, low-intermediate-risk prostate cancer appears favorable, and the side-effect profile is low. The 2007 Task Force criteria appear to reduce the positive biopsy rate in contralateral lobe after FC.

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Acknowledgments

This study was funded by National Natural Science Foundation of China (No. 81000247).

Author information

Correspondence to Hongqian Guo.

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Conflict of interest

All of authors declare that we have no conflict of interest.

Ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Huibo Lian and Junlong Zhuang contributed equally to the work.

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Lian, H., Zhuang, J., Yang, R. et al. Focal cryoablation for unilateral low-intermediate-risk prostate cancer: 63-month mean follow-up results of 41 patients. Int Urol Nephrol 48, 85–90 (2016). https://doi.org/10.1007/s11255-015-1140-8

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Keywords

  • Prostatic neoplasms
  • Carcinoma
  • Cryoablation
  • Focal