Oncological outcome after primary prostate cryoablation compared with radical prostatectomy: a single-centre...

Area of Science:

• Urology
• Oncology
• Surgical Innovation

Background:

• Radical prostatectomy (RP) is an established treatment for localized prostate cancer.
• Cryoablation of the prostate (CAP) emerged as an alternative treatment option.
• Evaluating the long-term oncological outcomes of CAP is crucial for patient management.

Purpose of the Study:

• To assess the oncological outcomes of whole-gland cryoablation of the prostate (CAP).
• To compare CAP outcomes with radical prostatectomy (RP) over a 7-year period.
• To determine recurrence rates across different risk groups following CAP.

Main Methods:

• Prospective registration of 40 whole-gland CAP procedures on 39 patients (2006-2012).
• Minimum 12-month follow-up for patients without recurrence; recurrence defined by Phoenix criterion.
• Comparison with oncological outcomes of 350 patients who underwent RP during the same timeframe.

Main Results:

• Median follow-up for CAP was 29.5 months; 33% of patients developed recurrence.
• Recurrence rates in CAP low-, intermediate-, and high-risk groups were 33%, 24%, and 46%, respectively.
• Recurrence rate after RP was 18% (3% low, 21% intermediate, 28% high risk); CAP showed significantly higher recurrence (p < 0.001).

Conclusions:

• Cryoablation of the prostate (CAP) resulted in high recurrence rates irrespective of risk group.
• Even small, low-risk prostate tumors treated with CAP demonstrated potential for recurrence.
• Oncological outcomes following CAP were inferior compared to radical prostatectomy (RP).