1639 ACHIEVING THE “TRIFECTA” USING FOCAL CRYOTHERAPY AS A PRIMARY TREATMENT FOR PROSTATE CANCER: COLD REGISTRY DATA

Abstract

You have accessJournal of UrologyProstate Cancer: Localized1 Apr 20111639 ACHIEVING THE “TRIFECTA” USING FOCAL CRYOTHERAPY AS A PRIMARY TREATMENT FOR PROSTATE CANCER: COLD REGISTRY DATA Philippe E. Spiess, Robert Given, Vladimir Mouraviev, and J. Stephen Jones Philippe E. SpiessPhilippe E. Spiess Tampa, FL More articles by this author , Robert GivenRobert Given Norfolk, VA More articles by this author , Vladimir MouravievVladimir Mouraviev Cincinnati, OH More articles by this author , and J. Stephen JonesJ. Stephen Jones Cleveland, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1748AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES In the present study, we evaluate the ability to achieve the therapeutic “trifecta” with focal cryotherapy using the COLD (Cryo On-Line Data) Registry. Focal cryotherapy was conducted using various templates of cryoablation. The “trifecta” being defined as (post-treatment): (1) achieving a nadir serum PSA < 0.6 ng/ml based on publication suggesting this surrogate, (2) no urinary incontinence, and (3) ability to have sexual intercourse (with or without intervention). METHODS A prospectively, centrally collected secure online database has been developed of patients undergoing focal cryoablation (using various partial gland templates) for localized prostate cancer. Of the 1214 patients undergoing focal cryotherapy which are included within the COLD Registry, complete medical records pertaining to continence status, ability to maintain sexual activity, and serial PSA measurements post-treatment were available in 308 patients, with the therapeutic “trifecta” achieved in 156 of these patients (51%). RESULTS Of the patient achieving the “trifecta”, the mean age at presentation was 65.9 years (+/− 8.0 years). The majority of patients had a baseline PSA < 10 ng/m, a clinical stage < T2b, and a biopsy Gleason score < 8 (85%, 84%, and 95%; respectively). The 1, 2, and 5 year actuarial biochemical failure rates using the Phoenix definition (nadir + 2 ng/ml) were 96.2%, 95.0%, and 93.2%, respectively. Following focal cryotherapy, urinary retention occurred in 3 (1.9%) and urethral fistulas in 1 (0.6%) of patients. CONCLUSIONS Focal cryotherapy has been evaluated as a potential treatment choice for well selected patients in an attempt to minimize morbidity without compromising oncological outcome in patients with low volume disease. The present study highlights that only 51% of patients achieved the therapeutic “trifecta” raising into question its true benefit over established treatment choices for localized prostate cancer. We do acknowledge however that the templates of focal cryoablation varied significantly within this cohort of patients. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e658 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Philippe E. Spiess Tampa, FL More articles by this author Robert Given Norfolk, VA More articles by this author Vladimir Mouraviev Cincinnati, OH More articles by this author J. Stephen Jones Cleveland, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...