Partial gland ablation for radio-recurrent prostate cancer: Short-term oncological and functional outcomes.

INTRODUCTION AND

OBJECTIVE

To assess outcomes and complications of partial gland cryoablation (sCRYO) and high-intensity focused ultrasound (sHIFU) for localized radio-recurrent prostate cancer (CaP).

METHODS

Fifty-one consecutive patients who underwent focal therapy with curative intent for localized radio-recurrent CaP (sCRYO or sHIFU) between 2011 and 2023 were included (IRB# HS-17-00749). Patients were monitored by prostate biopsy (PBx) 6 to 12 months and every 2 year thereafter. The primary endpoint was treatment failure (TF) defined as any radical treatment, systemic therapy, metastases, or CaP-specific mortality. Secondary endpoints were survival-free from (1) biochemical failure (BF, PSA nadir + 2 ng/ml); (2) clinically significant prostate cancer (CSCaP) on follow-up PBx, and (3) radical treatment. Functional outcomes were assessed by the International Prostate Symptom Score (IPSS) and the International Index of Erectile Function (IIEF-5). The 90-day Clavien-Dindo complications are recorded. Statistically significant if P < 0.05.

RESULTS

A total of 51 patients with radio-recurrent CaP were included. Of these, 41 and 10 underwent sCRYO and sHIFU, respectively. Median baseline characteristics were as follows: age 71 years, PSA 4.48 ng/dl, prostate volume 26 cc. PSA density (PSAD) 0.15 ng/ml2. The short-term free survival rates for TF, CSCaP, Biochemical failure, and radical treatment were 95%, 84%, 76%, and 98%, respectively. The median differences from pre to post-treatment IPSS and IIEF-5 were 0 and 1, respectively. A total of 48 (95%) patients remained continent at follow-up. The 90-day complication rate was 4%.

CONCLUSION

Partial gland cryotherapy and HIFU for radio-recurrent localized nonmetastatic CaP provide acceptable 2-year oncologic and functional outcomes, with low perioperative complications.