Primary cryoablation nadir prostate specific antigen and biochemical failure

Area of Science:

• Oncology
• Urology

Background:

• Prostate cancer is a significant health concern, with cryoablation emerging as a treatment option.
• Assessing treatment efficacy is crucial for patient management and long-term outcomes.

Purpose of the Study:

• To correlate nadir prostate specific antigen (PSA) levels post-cryoablation with long-term biochemical disease-free survival.
• To evaluate the prognostic value of PSA in risk-stratified prostate cancer patients treated with cryoablation.

Main Methods:

• Analysis of data from 2,427 patients in the Cryo On-Line Data Registry.
• Biochemical disease-free survival was assessed using PSA levels up to 60 months post-cryoablation, based on nadir + 2 criteria.
• Patients were stratified into low, intermediate, and high-risk groups.

Main Results:

• For nadir PSA < 0.1 ng/ml, 60-month survival rates ranged from 71% (high-risk) to 91.8% (low-risk).
• For nadir PSA 0.1-0.5 ng/ml, 60-month survival rates ranged from 51% (high-risk) to 86% (low-risk).
• PSA levels of 0.6 ng/ml or greater were associated with a 29.5% biochemical failure rate at 24 months, irrespective of risk group.

Conclusions:

• Nadir PSA after prostate cryoablation serves as a prognostic indicator for biochemical disease-free survival.
• A nadir PSA of 0.6 ng/ml or higher warrants close follow-up due to a significant biochemical failure rate.
• Nadir PSA alone is insufficient to define disease-free survival without correlation to disease-specific or metastasis-free survival.