Abstract:

Objective: This study aimed to analyze the outcomes of patients with recurrent prostate cancer (PCa) who received salvage cryotherapy (SC) in our institution. Biochemical recurrence (BCR) after definitive radiotherapy or brachytherapy for PCa is usually managed with long-term androgen-deprivation therapy (ADT). In selected cases, salvage therapies might delay ADT and its side effects. Materials and Methods: All patients who received SC from 2014 to 2018 in our institution were evaluated retrospectively. Results: A total of 17 patients were included, with a median age at SC of 72.0 (range 60-77) years. The median prostate-specific antigen (PSA) before SC was 4.25 [interquartile range (IQR) 3.1-7.6] ng/mL. The median time to BCR was 18.8 (IQR 13.5-32.1) months after SC. The median PSA nadir after SC was 0.49 (IQR 0.09-1.0) ng/mL. With a median follow-up of 43 (range, 11-78) months, 7 (41%) patients had a recurrence. Of those patients, two received ADT, while others were managed conservatively. The biochemical progression-free survival (bPFS) time of patients with PSA nadir <0.5 ng/mL was 56.0 vs. 22.5 months (log-rank test, p=0.012). Gleason score ≥8 at diagnosis and PSA before SC >8 ng/mL were also associated with shorter bPFS (log-rank test, p<0.05). De novo urinary incontinence was reported in 5 (29.4%) patients. The 3- and 5-year PCa-specific survival rates were 93.3% and 85.6%, respectively. Conclusion: SC might be considered with acceptable oncological and functional results. Until randomized controlled trials are performed and available, series such as ours may help widen our views on all therapeutic possibilities after primary treatment failure in PCa.

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