Oncological outcome after primary prostate cryoablation compared with radical prostatectomy: A single-centre experience

Abstract

Objective. The aim of this study was to evaluate the oncological outcome after cryoablation of the prostate (CAP) in localized prostate cancer and to compare the results with those of the established treatment of radical prostatectomy (RP) after 7 years of parallel use. Material and methods. Forty primary, whole-gland CAP procedures performed on 39 patients from 2006 until 2012 at the Department of Urology, Aarhus University Hospital, were prospectively registered. Patients had a minimum of 12 months' follow-up if they had no recurrent disease. Recurrence was defined by the Phoenix criterion (nadir PSA + 2 ng/ml). Results were compared with oncological outcome in 350 patients who underwent RP over the same period. Results. Median follow-up after CAP was 29.5 (range 4–75) months. Median age at the time of treatment was 65 (47–78) years. A total of 13 (33%) patients developed recurrent disease after CAP, and in D'Amico low-, intermediate- and high-risk subgroups, recurrence was found in two (33%), five (24%) and six (46%), respectively. Median follow-up after RP was 37 (16–54) months. No cases were excluded. Median age was 64 (34–76) years. Compared with the RP results, where recurrence was found in 62 cases in total (18%), and in three (3%), 30 (21%) and 29(28%) subdivided into risk groups, the risk of recurrent disease was significantly higher after the CAP procedures (p < 0.001). Conclusions. Recurrence after CAP was high regardless of risk group, indicating a risk of treating and leaving the tumour in situ. Even small low-risk tumours have the potential for recurrence. At this institution, the oncological outcome after CAP was inferior to that after RP.