Abstract

You have accessJournal of UrologyCME1 Apr 2023MP73-06 OUTCOMES OF SALVAGE CRYOTHERAPY FOR BIOCHEMICAL RECURRENCE FOLLOWING PRIMARY RADIOTHERAPY IN THE MANAGEMENT OF PROSTATE CANCER - 14-YEARS SINGLE INSTITUTION EXPERIENCE Gregory Mansour, Andrew Wang, and Robert Given Gregory MansourGregory Mansour More articles by this author , Andrew WangAndrew Wang More articles by this author , and Robert GivenRobert Given More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Salvage cryotherapy of the prostate remains a treatment option for biochemical recurrence (BCR) following either radiotherapy or other local ablative therapies of prostate cancer. Previous studies have assessed long-term oncologic results to include overall disease survival in addition to freedom from starting ADT. We aim to assess oncologic outcomes in addition to de novo stricture, fistula, urinary incontinence, and erectile dysfunction rates. METHODS: We retrospectively reviewed all men who underwent salvage cryotherapy following external beam radiation therapy (EBRT), proton beam therapy, primary cryotherapy, and brachytherapy at our institution from 2005 through 2019. Functional and oncologic outcomes were assessed. Biochemical recurrence-free survival was defined based on a combination of the Phoenix and Astro criteria and analyzed using Kaplan-Meier statistics. RESULTS: Of the total 85 patients included, 71 had primary EBRT, 9 had brachytherapy, 3 had combined EBRT and brachytherapy, and 2 had proton beam therapy. All patients had negative staging workups prior to salvage therapy. Recto-urethral fistulas occurred in 2 patients (2.3%), 21 patients (24.4%) developed urethral strictures, and 23 patients (26.7%) reported de novo incontinence requiring pads. 5- year overall biochemical free survival was 49%. A total of 53% of subjects had biochemical recurrence with a mean time of 39 months after salvage treatment. Overall cancer specific survival was 86% and metastasis free survival was 77.9%. There was not a statistically significant correlation identified between pretreatment PSA and timing to BCR R2=0.05 p=0.129. One patient did not have a PSA response after salvage cryotherapy and went on to develop metastatic disease. CONCLUSIONS: Salvage cryotherapy remains one of the few potentially curative interventions following primary radiotherapy for prostate cancer. This study highlights the necessity for patient counseling given the side effect profile. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1036 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gregory Mansour More articles by this author Andrew Wang More articles by this author Robert Given More articles by this author Expand All Advertisement PDF downloadLoading ...

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