Salvage focal cryosurgery may delay use of androgen deprivation therapy in cryotherapy and radiation recurrent prostate cancer patients.

Autor: Kongnyuy M; a Department of Urology , Winthrop University Hospital , Garden City , NY , USA., Berg CJ; b New York Institute of Technology College of Osteopathic Medicine , Old Westbury, NY , USA., Kosinski KE; a Department of Urology , Winthrop University Hospital , Garden City , NY , USA., Habibian DJ; c Saint George's University School of Medicine , Saint George , GD , USA., Schiff JT; a Department of Urology , Winthrop University Hospital , Garden City , NY , USA., Corcoran AT; a Department of Urology , Winthrop University Hospital , Garden City , NY , USA., Katz AE; a Department of Urology , Winthrop University Hospital , Garden City , NY , USA.
Jazyk: angličtina
Zdroj: International journal of hyperthermia : the official journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group [Int J Hyperthermia] 2017 Nov; Vol. 33 (7), pp. 810-813. Date of Electronic Publication: 2017 Mar 29.
DOI: 10.1080/02656736.2017.1306121
Abstrakt: Introduction: Salvage treatment options for recurrent unilateral prostate cancer (PCa) after primary radiation are limited and associated with severe complications and poor quality of life measures. Salvage focal cryotherapy (SFC) has shown success in biochemical recurrence (BCR) free survival. We aim to determine if SFC can delay use of androgen deprivation therapy (ADT) in recurrent PCa with low morbidity.
Methods: A retrospective review of patients who underwent SFC at our institution from 2007 to 2015 was performed. Patients with <2 follow-up prostate-specific antigen (PSA) values, metastatic disease, and a history of radical prostatectomy were excluded. Age at treatment, prior treatment history, PSA nadir, complications, BCR status (nadir +2 ng/ml), and follow-up data were obtained/analysed. ADT was commenced if patient experienced BCR and had a PSA doubling time <6 months or positive confirmatory biopsy or positive imaging. Cox regression and survival analysis were used to assess confounding and time to BCR respectively.
Results: A total of 65 patients were included and followed for a median of 26.6 (8.0-99.0) months. Thirty-one (47.7%) patients did not experience BCR. An even higher number of patients (52/65, 80.0%) are yet to receive ADT. Of those who experienced BCR [median time to BCR, 17.1 [interquartile range (IQR):11.4-23.3] months], 22/34 (64.7%) are currently carefully monitored without ADT. Survival analysis showed a biochemical recurrence-free survival of 48.1 at 1- and 3-year follow up. No patient died/experienced major complications.
Conclusions: SFC may be used to delay the use of ADT. Further assessment of our findings with high-powered studies and longer follow-up is required.
Databáze: MEDLINE
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