Third-generation salvage cryotherapy for radiorecurrent prostate cancer: a centre's experience

Urol Int. 2012;88(2):137-44. doi: 10.1159/000332220. Epub 2012 Jan 24.

Abstract

Introduction: The experience of a tertiary centre in the management of recurrent prostate cancer after radiotherapy by salvage cryotherapy is presented.

Patients and methods: Between February 2006 and August 2008, 19 patients underwent salvage cryotherapy for radiorecurrent prostate cancer. Post-radiotherapy recurrence was confirmed by prostatic biopsy. The 'Phoenix definition' was used to define biochemical failure after salvage cryotherapy.

Results: The mean age at cryotherapy was 69.2 years and the mean time from radiotherapy to cryotherapy was 72.3 months. Patient characteristics prior to cryotherapy included a mean PSA level of 6.84 ng/ml and a median Gleason score of 7. The mean post-cryotherapy follow-up was 33.3 months. The 2-year biochemical disease-free survival rate was 58%. The median post-cryotherapy PSA nadir was 0.20 ng/ml (range 0.005-8.260). There were no procedure-related or cancer-related deaths. Complications included incontinence (10.5%), erectile dysfunction (89%) and fistula formation (5.3%).

Conclusions: The relatively high rates of biochemical response support the use of cryotherapy as a salvage procedure for radiorecurrent prostate cancer.

MeSH terms

  • Aged
  • Biopsy
  • Cryotherapy* / adverse effects
  • Disease-Free Survival
  • Humans
  • Kaplan-Meier Estimate
  • London
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Recurrence, Local*
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / blood
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy
  • Prostatic Neoplasms / therapy*
  • Radiation Tolerance*
  • Retrospective Studies
  • Salvage Therapy* / adverse effects
  • Time Factors
  • Treatment Failure
  • Treatment Outcome

Substances

  • Prostate-Specific Antigen