PD56-09 PSA TRENDS FOLLOWING PRIMARY FOCAL CRYOSURGERY FOR EARLY STAGE PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Ablative Therapy II1 Apr 2017PD56-09 PSA TRENDS FOLLOWING PRIMARY FOCAL CRYOSURGERY FOR EARLY STAGE PROSTATE CANCER Michael Kongnyuy, Shahidul Islam, Daniel Halpern, Kaitlin Kosinski, Jose Salcedo, Jeffrey Schiff, Anthony Corcoran, and Aaron Katz Michael KongnyuyMichael Kongnyuy More articles by this author , Shahidul IslamShahidul Islam More articles by this author , Daniel HalpernDaniel Halpern More articles by this author , Kaitlin KosinskiKaitlin Kosinski More articles by this author , Jose SalcedoJose Salcedo More articles by this author , Jeffrey SchiffJeffrey Schiff More articles by this author , Anthony CorcoranAnthony Corcoran More articles by this author , and Aaron KatzAaron Katz More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2598AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Determination of biochemical (BCR) recurrence in patients who undergo primary focal cryosurgery (PFC) for organ confined prostate cancer (PCa) is controversial. We aim to evaluate prostate specific antigen (PSA) trends in post PFC patients. METHODS A single-center retrospective review of patients from our IRB-approved database who underwent PFC was performed. Patients were followed with serial PSAs and BCR was determined using the Phoenix (PD: PSA nadir + 2 ng/ml) and Stuttgart (SD: PSA nadir + 1.2 ng/ml) definitions. PSA bounce was assessed using 2 different definitions (B1: increase in PSA of 0.4 in first 6 months and any drop thereafter, B2: increase in PSA of ≥0.2 above nadir and then a drop to/below nadir) Age, prostate volume, D′Amico risk, Gleason score, PSA variables and kinetics overtime were assessed between those who experienced BCR versus not. Various PSA permutations were analyzed. RESULTS 123 (94.6%) consecutive patients who had >1 PSA follow-up values were included in our analysis. Median (range) age and follow-up time was 66 (48-82) years and 19 (6.3-68.6) months respectively. 11 (8.9%, 7B1; 4B2) patients experienced PSA bounce and a median percent drop in first post-PFC PSA of 80.0 (0.0-98.7) was not associated with BCR, p=0.301. PSA values in both groups increased over time but the rate of change was significantly higher in patients who experienced BCR compared to those who did not [median PSA velocity: 0.1 vs 0.04, p=0.003]. Other PSA variables associated with experiencing BCR were higher pre-PFC PSA (7.2 vs 5.4 ng/ml, p=0.003) and higher PSA nadir (1.3 vs 1 ng/ml, p=0.012). CONCLUSIONS Higher PSA velocity, nadir and pre-PFC PSA may help raise suspicion for BCR. In the future with validation, these variables could serve as the components of PFC-specific BCR criteria. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1119 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Michael Kongnyuy More articles by this author Shahidul Islam More articles by this author Daniel Halpern More articles by this author Kaitlin Kosinski More articles by this author Jose Salcedo More articles by this author Jeffrey Schiff More articles by this author Anthony Corcoran More articles by this author Aaron Katz More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...