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Predictors of Early and Late Oncologic Failure After Primary Prostate Cryoablation for Localized Prostate Cancer
Salvatore Basile1, Leonardo Misuraca1, Riccardo Mastroianni1
1Uro-Oncology Program - IRCCS Regina Elena National Cancer Institute, Rome, Italy.
Clinical Genitourinary Cancer
|March 6, 2026
Summary
Early prostate cancer cryoablation failure is linked to ablation extent, while late recurrence depends on tumor grade. Understanding these factors improves patient selection and surveillance after cryotherapy.
Area of Science:
- Oncology
- Urology
- Medical Physics
Background:
- Prostate cancer (PCa) cryoablation outcomes can be unpredictable.
- Identifying factors for early and late oncologic failure is crucial for treatment optimization.
Purpose of the Study:
- To investigate clinical and procedural predictors of early (≤ 24 months) and late (> 24 months) oncologic failure after primary prostate cancer cryoablation.
Main Methods:
- 221 men with PCa underwent primary cryoablation.
- Failure-free survival (FFS) defined by biochemical recurrence, progression, or salvage therapy.
- Firth logistic regression analyzed predictors, distinguishing early and late failure events.
Main Results:
- Early failure (4.1%) linked to ablation extent; late failure (8.1%) associated with ISUP grade group.
- Whole-gland ablation showed protective effects against both early and late failure.
- Functional outcomes like continence and erectile recovery were generally preserved.
Conclusions:
- Early cryoablation failures are primarily related to the extent of tissue ablated.
- Late recurrence is significantly influenced by the tumor's intrinsic grade (ISUP grade group).
- This temporal distinction aids in interpreting recurrence patterns and refining patient selection/surveillance strategies.
