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Updated: Apr 17, 2026

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance

Published on: November 7, 2025

Second Therapeutic Freeze After Salvage Cryoablation for Localized Radiorecurrent Prostate Cancer.

Sudharshanan Balaji^1,2, Mahdi Mottaghi³, Paul P Koffer⁴

¹Department of Urology, Duke University Medical Center, Durham, North Carolina, USA.

|April 15, 2026

Summary

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This summary is machine-generated.

A second therapeutic freeze (STF) after salvage cryoablation (sCryo) for prostate cancer recurrence can preserve function and defer treatment. While oncologic outcomes are not equivalent to primary therapy, STF offers a feasible option for local control in select patients.

Area of Science:

Urology
Oncology
Cryoablation Therapy

Background:

Localized prostate cancer treatment can involve radiotherapy followed by salvage cryoablation (sCryo).
Local recurrence after sCryo necessitates further therapeutic strategies.
The role of a second therapeutic freeze (STF) following sCryo for recurrent prostate cancer requires investigation.

Purpose of the Study:

To evaluate the long-term oncologic and functional outcomes of STF after sCryo in patients with biopsy-proven prostate cancer recurrence.
To assess urinary and erectile function, complications, and survival endpoints following STF.

Main Methods:

Retrospective review of 10 men with local recurrence after radiotherapy and sCryo who underwent STF.
Assessment of urinary continence (0-1 pad/day) and erectile function (IIEF-5 score ≥17).

Keywords:

ablation techniques cryosurgery local neoplasm recurrence prostatic neoplasms radiotherapy salvage therapy

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Evaluation of oncologic endpoints including failure-free survival (FFS), metastasis-free survival (MFS), cancer-specific survival (CSS), and overall survival (OS).

Main Results:

At a median follow-up of 77 months, 5-year FFS was 52.5%, MFS was 80.0%, CSS was 87.5%, and OS was 75.0%.
Post-STF, 7/10 men achieved social continence and 6/10 were pad-free at 1 year; potency was maintained in previously potent men.
No severe complications (Clavien-Dindo ≥III) occurred, with one rectourethral fistula observed.

Conclusions:

STF after sCryo appears to be a feasible and safe option for preserving genitourinary function and deferring androgen deprivation therapy (ADT) in select patients.
While oncologic outcomes are not equivalent to primary treatment, STF can extend local control in carefully selected candidates.
Larger, prospective studies are warranted to confirm these findings and guide broader clinical application.