MP73-14 BIOPSY ASSESSMENT OF ONCOLOGIC CONTROL THREE YEARS FOLLOWING PRIMARY PARTIAL GLAND CRYOABLATION (PPGCA)

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You have accessJournal of UrologyCME1 Apr 2023MP73-14 BIOPSY ASSESSMENT OF ONCOLOGIC CONTROL THREE YEARS FOLLOWING PRIMARY PARTIAL GLAND CRYOABLATION (PPGCA) Herbert Lepor, Eli Rapoport, Rozalba Gogaj, and James Wysock Herbert LeporHerbert Lepor More articles by this author , Eli RapoportEli Rapoport More articles by this author , Rozalba GogajRozalba Gogaj More articles by this author , and James WysockJames Wysock More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003341.14AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: mpMRI coupled with MR targeted biopsy reliably identifies candidates for PPGCA harboring unifocal clinically significant prostate cancer (csPCa). The present study reports 3-year oncological outcomes following PPGCA in a cohort of men with unilateral intermediate risk prostate cancer undergoing surveillance biopsies at 6 months and 2-years METHODS: Men with unilateral intermediate risk prostate cancer undergoing PPGCA between 3/2017 and 5/2020 were enrolled in a prospective outcome registry. The post-ablation surveillance protocol for all men included PSA testing every six months and mpMRI at six months and 2 years. Surveillance prostate biopsy was initially recommended at six months and subsequently in all men at 2-years. Recurrence of csPCa was defined as any Gleason Grade Group>1 disease at any time point. Freedom-from-failure represented no whole-gland salvage treatment, metastatic prostate cancer, or prostate cancer mortality. Kaplan-Meier survival curves captured recurrence of csPCa and freedom-from-failure (Figure 1). RESULTS: 122 men had at least 24 months of follow-up data. Surveillance biopsies identified csPCa in 13 (17.3%) of evaluable men. At 36 months, biopsy detection survival rate for in-field, out-of-field and overall csPCa was 96.1% (95% CI: 91.9-100.0), 84.8% (95% CI: 77.3-93.2), and 83.5% (95% CI: 75.6-92.2), respectively (Figure 1). The probability of freedom-from-failure at 36 months was 97.3% (95% CI: 93.6-100.0) (Figure 1). Of the 13 men with csPCa, 4,5,2 and 2 were managed with active surveillance, salvage PGCA, salvage RP and two refused whole gland treatment, respectively. The sensitivity of mpMRI for any csPCa was 38% CONCLUSIONS: The low in-field cancer detection rate at 3 -years indicates successful ablation of localized cancers. Conversely, the out-of-field detection rate of 15% highlights the need for continued surveillance The increasing time-dependent risk for detecting out of field csPCa emphasizes the need for long-term surveillance and identification of predictors of csPCa recurrences which would guide necessity and timing of surveillance biopsies. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1040 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Herbert Lepor More articles by this author Eli Rapoport More articles by this author Rozalba Gogaj More articles by this author James Wysock More articles by this author Expand All Advertisement PDF downloadLoading ...