468 IMPACT OF DISEASE BURDEN ON CRYOABLATION PSA OUTCOMES

Abstract

You have accessJournal of UrologyProstate Cancer: Localized II1 Apr 2010468 IMPACT OF DISEASE BURDEN ON CRYOABLATION PSA OUTCOMES David Levy and Stephen Jones David LevyDavid Levy More articles by this author and Stephen JonesStephen Jones More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.541AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To identify prognostic factors for favorable biochemical outcome (PSA < 0.6 ng/ml) following primary whole gland prostate cryoablation. METHODS The charts from 122 cryoablation patients treated at Cleveland Clinic from 2004 through May 2009 were reviewed. Patient age, race, PSA at diagnosis, Gleason score, risk category, prostate gland volume, clinical T stage, number of cores positive, percent of core involved with disease, ratios of: number of cores positive to total cores biopsied and number of cores positive to prostate gland volume, and initial PSA results were studied. An initial PSA of < 0.6 was employed as the criterion for favorable outcome based on previously published data. RESULTS 16.4% of patients had unfavorable postoperative PSA levels. On univariate analysis, number of cores positive (p= 0.0312) and maximum percent core positive (0.0236) were prognostic of PSA outcome. On multivariate analysis, number of cores positive (p=0.0097), maximum percent core positive (p= 0.0337) and ratio of number of positive cores to prostate gland volume (p=0.0225) were prognostic for favorable PSA outcomes based on an initial PSA < 0.6 ng/ml. CONCLUSIONS This is the first published report of prognostic factors for favorable PSA outcomes following primary prostate cryoablation. The relative disease burden as defined by the number of and percent core positive, and the ratio of number of cores positive to prostate gland volume are highly prognostic for initial post cryoablation PSA < 0.6 ng/ml which is associated with favorable long term biochemical disease free survival regardless of risk stratification. Table 1. Logistic regression analysis of PSA < 0.6; univariate and multivariate results. Variable Coefficient (S.E.) p-value Univariate analysis Age -0.0378 (0.0356) 0.2875 Race -0.1252 (0.6803) 0.8526 Initial PSA -0.0356 (0.0325) 0.2745 Volume -0.0005 (0.0219) 0.9834 Gleason scores -0.2558 (0.2377) 0.2818 No. positive cores -0.1729 (0.0803) 0.0312 Max% of positive cores -0.0208 (0.0092) 0.0236 Risk groups criteria -0.0114 (0.5216) 0.9825 No. positive cores / total no. -1.508 (1.1185) 0.1776 No. positive cores / volume -0.8966 (1.8978) 0.6366 Multivariate analysis No. positive cores -0.6898 (0.2665) 0.0097 Max% positive cores -0.0255 (0.012) 0.0337 No. positive cores / volume 18.2113 (7.9794) 0.0225 Cleveland, OH© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e184-e185 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Levy More articles by this author Stephen Jones More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...