PD56-04 SALVAGE PROSTATE CRYOABLATION IN OLDER MEN

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II1 Apr 2017PD56-04 SALVAGE PROSTATE CRYOABLATION IN OLDER MEN J. Kellogg Parsons, Ashley Ross, Ahmed El Shafei, Asmaa Hatem, Britney Cotta, Kae Jack Tay, Thomas Polascik, Robert Given, Vladimir Mouraviev, and J Stephen Jones J. Kellogg ParsonsJ. Kellogg Parsons More articles by this author , Ashley RossAshley Ross More articles by this author , Ahmed El ShafeiAhmed El Shafei More articles by this author , Asmaa HatemAsmaa Hatem More articles by this author , Britney CottaBritney Cotta More articles by this author , Kae Jack TayKae Jack Tay More articles by this author , Thomas PolascikThomas Polascik More articles by this author , Robert GivenRobert Given More articles by this author , Vladimir MouravievVladimir Mouraviev More articles by this author , and J Stephen JonesJ Stephen Jones More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2593AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Outcomes of salvage prostate cryosurgery in older men remain undefined. We evaluated oncological and functional outcomes after salvage full gland prostate cryoablation in men over age 75 years. METHODS We identified 923 men who underwent salvage full gland prostate cryoablation for recurrent prostate cancer after primary radiotherapy, including 240 (26%) > 75 years at time of surgery. Primary outcomes were progression-free survival (PFS) using Phoenix criteria and post-treatment biopsy status. Secondary outcomes included post-treatment urinary incontinence, erectile dysfunction (ED), rectal fistulae, and urinary retention. RESULTS Mean follow-up was 26 months (SD±30). Compared to men ≤ 75 years, men > 75 years were more likely to have pre-treatment Gleason sum ≥7 disease (71% vs.63%, p=0.03) and less likely to have undergone neoadjvuant androgen deprivation therapy (29% vs. 37%, p=0.02) (Table 1). In Kaplan Meir analyses, there were no significant differences in 5-year PFS between groups: 61% versus 57% for men > 75 and ≤ 75 years, respectively (p=0.43) (Figure 1). Post-treatment biopsy was positive in 34% versus 29% of men >75 years and ≤ 75 years, respectively (p=0.5). Older men were more likely to have post-treatment urinary retention (23% versus 15%, p=0.003). There were no significant differences in recto-urethral fistulae (3% versus 2%, p=0.62), urinary incontinence (32% versus 30%, p=0.48), or new onset ED (54% versus 49%, p=0.63) between groups (Table 1). CONCLUSIONS Salvage whole gland cryoablation of the prostate in men > 75 years is associated with robust progression-free survival and functional outcomes comparable to younger men. Prostate cryoablation should be considered in older men with recurrent disease after primary radiotherapy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1116-e1117 Advertisement Copyright & Permissions© 2017MetricsAuthor Information J. Kellogg Parsons More articles by this author Ashley Ross More articles by this author Ahmed El Shafei More articles by this author Asmaa Hatem More articles by this author Britney Cotta More articles by this author Kae Jack Tay More articles by this author Thomas Polascik More articles by this author Robert Given More articles by this author Vladimir Mouraviev More articles by this author J Stephen Jones More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...