1475 FACTORS PREDICTIVE OF DEVELOPING COMPLICATIONS FOLLOWING PRIMARY AND SALVAGE CRYOABLATION OF THE PROSTATE

Abstract

You have accessJournal of UrologyProstate Cancer: Localized VII1 Apr 20121475 FACTORS PREDICTIVE OF DEVELOPING COMPLICATIONS FOLLOWING PRIMARY AND SALVAGE CRYOABLATION OF THE PROSTATE Edward N. Rampersaud, Frederic D. Birkhauser, Yvonne Chan, Joshua E. Logan, Alex Wonnaparhown, Geoffrey Sonn, and Arie S. Belldegrun Edward N. RampersaudEdward N. Rampersaud Los Angeles, CA More articles by this author , Frederic D. BirkhauserFrederic D. Birkhauser Los Angeles, CA More articles by this author , Yvonne ChanYvonne Chan Los Angeles, CA More articles by this author , Joshua E. LoganJoshua E. Logan Los Angeles, CA More articles by this author , Alex WonnaparhownAlex Wonnaparhown Los Angeles, CA More articles by this author , Geoffrey SonnGeoffrey Sonn Los Angeles, CA More articles by this author , and Arie S. BelldegrunArie S. Belldegrun Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1996AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Cryoablation of the prostate is a treatment option for selected patients with prostate cancer in both primary and salvage settings. We sought to assess factors predictive of developing various treatment-related complications in a single-surgeon practice at a quaternary-care institution. METHODS The UCLA Prostate Cancer Program cryotherapy database contains records of 144 consecutive patients treated with identical cryotherapy equipment in an outpatient setting since 2005. Of these patients, 68 were treated with primary cryotherapy (Primary) and 76 with salvage cryotherapy (Salvage) after primary radiotherapy. A verbal questionnaire regarding possible complications was administered to all patients contacted by an independent research monitor. Clinicopathologic factors were compared and binary logistic regression models were employed to assess the factors predictive of individual complications. RESULTS Average age for patients in Primary and Salvage groups were 70.8 and 72.4 years (p=0.748). The two groups were also balanced for other baseline demographic variables, including race, body mass index (BMI), and pretreatment PSA. Prostate volume was significantly greater in Primary group than Salvage group (41.4cc and 26.1cc, p<0.001). Low-risk Gleason was more commonly treated in the Primary group (p=0.011). Incontinence (more than one pad per day), urethral strictures, and post-treatment erectile dysfunction (ED) were more common in the Salvage group (34.7% vs 16.7%, p=0.013), (16.0% vs 2.82%, p=0.007), and (81.6% vs 59.7%, p=0.003). Urinary retention, bladder overactivity, fistulae, and hematuria were similar among the groups. In total, 85% Primary patients and 75% Salvage patients were free from major complication (stricture, fistula, new-onset ED) at a median follow-up of 56 months. Number of needles used was independently associated with the development of incontinence (HR=1.22, 95% CI 1.02-1.47, p=0.034). Prostate volume (HR=1.14, 95% CI 1.01-1.3, p=0.05) and number of probes used (HR=1.62, 95% CI 1.03-2.58, p=0.044) were independently associated with development of urethral strictures. Salvage cryotherapy was significantly more likely to predict development of post-treatment erectile dysfunction (HR=4.33, 95% CI 1.08-17.46, p=0.039). CONCLUSIONS Major complications after cryotherapy of the prostate are relatively uncommon, though they are more likely to occur in the salvage setting. Cryotherapy for prostate cancer can be safely performed in appropriately selected patients. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e598 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Edward N. Rampersaud Los Angeles, CA More articles by this author Frederic D. Birkhauser Los Angeles, CA More articles by this author Yvonne Chan Los Angeles, CA More articles by this author Joshua E. Logan Los Angeles, CA More articles by this author Alex Wonnaparhown Los Angeles, CA More articles by this author Geoffrey Sonn Los Angeles, CA More articles by this author Arie S. Belldegrun Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...