TY - JOUR
T1 - Cryotherapy versus radical prostatectomy as a salvage treatment for radio-recurrent prostate cancer
AU - Rivas, Juan Gomez
AU - Taratkin, Mark
AU - Azilgareeva, Camilla
AU - Morozov, Andrey
AU - Laso, Silvia
AU - Enikeev, Dmitry
AU - Sierra, Jesus Moreno
AU - Schelkunova, Ksenia
AU - Sanguedolce, Francesco
AU - Breda, Alberto
AU - Govorov, Alexander
AU - Vasilyev, Alexander
AU - Cepeda, Marcos
AU - Lusuardi, Lukas
AU - Pallauf, Maximilian
AU - Celia, Antonio
AU - Silvestri, Tommaso
AU - Fiori, Cristian
AU - Fernandez, Esau
AU - Martinez-Salamanca, Juan Ignacio
AU - Barret, Eric
N1 - Lusuardi, Pallauf: Department of Urology and Andrology, Paracelsus
Medizinische Privatuniversität, Salzburg, Austria
PY - 2024/9/11
Y1 - 2024/9/11
N2 - Introduction The aim of this study is to compare outcomes of SRP (salvage radical prostatectomy) with SCAP (salvage cryoablation of the prostate) in local radio-recurrent PCa (prostate cancer) patients. Materials and methods A retrospective analysis of a multicentric European Society of Uro-technology (ESUT) database was performed. Data on patients with local recurrent PCa after radiotherapy who underwent salvage treatment were collected. Patients and their respective disease characteristics, perioperative complications as well as oncological outcomes were then described. The treatment success rate was defined as PSA nadir < 0,4 ng/ml. Any complications were graded according to the modified Clavien system. A descriptive and comparative analysis was performed using SPSS software. Results 25 patients underwent SRP and 71 patients received SCAP. The mean follow-up was 24 months. The median PSA level before initial treatment was 8.3 (range 7-127) ng/ml. The success rates of SRP and SCAP were largely comparable (88% (22 patients) vs. 67.7% (48 patients), respectively, p = 0.216). The mean serum PSA levels at 12 months after salvage treatment were 1.2 +/- 0.2 ng/mL vs. 0.25 +/- 0.5 ng/mL, p > 0.05). During the follow-up period, only 3 (12%) patients in the SRP group had PSA recurrence compared with 21 patients (29.6%) in the SCAP group. The 5-year BRFS was similar (51,6% and 48,2%, p = 0,08) for SRP and SCAP respectively. The 5-year overall survival rate was 91.7%, and 89,7% (p = 0.669) and the 5-year cancer-specific survival was 91.7%, and 97,1% (p = 0.077), after SRP and SCAP respectively. No difference was found regarding the complications. Conclusions Both SRP and SCAP should be considered as valid treatment options for patients with local recurrence of PCa after radiotherapy. SCAP has a potentially lower risk of morbidity and acceptable intermediate-term oncological efficacy, but a longer follow up and a higher number of patients is ideally needed to draw any long-term conclusions regarding the oncological data.
AB - Introduction The aim of this study is to compare outcomes of SRP (salvage radical prostatectomy) with SCAP (salvage cryoablation of the prostate) in local radio-recurrent PCa (prostate cancer) patients. Materials and methods A retrospective analysis of a multicentric European Society of Uro-technology (ESUT) database was performed. Data on patients with local recurrent PCa after radiotherapy who underwent salvage treatment were collected. Patients and their respective disease characteristics, perioperative complications as well as oncological outcomes were then described. The treatment success rate was defined as PSA nadir < 0,4 ng/ml. Any complications were graded according to the modified Clavien system. A descriptive and comparative analysis was performed using SPSS software. Results 25 patients underwent SRP and 71 patients received SCAP. The mean follow-up was 24 months. The median PSA level before initial treatment was 8.3 (range 7-127) ng/ml. The success rates of SRP and SCAP were largely comparable (88% (22 patients) vs. 67.7% (48 patients), respectively, p = 0.216). The mean serum PSA levels at 12 months after salvage treatment were 1.2 +/- 0.2 ng/mL vs. 0.25 +/- 0.5 ng/mL, p > 0.05). During the follow-up period, only 3 (12%) patients in the SRP group had PSA recurrence compared with 21 patients (29.6%) in the SCAP group. The 5-year BRFS was similar (51,6% and 48,2%, p = 0,08) for SRP and SCAP respectively. The 5-year overall survival rate was 91.7%, and 89,7% (p = 0.669) and the 5-year cancer-specific survival was 91.7%, and 97,1% (p = 0.077), after SRP and SCAP respectively. No difference was found regarding the complications. Conclusions Both SRP and SCAP should be considered as valid treatment options for patients with local recurrence of PCa after radiotherapy. SCAP has a potentially lower risk of morbidity and acceptable intermediate-term oncological efficacy, but a longer follow up and a higher number of patients is ideally needed to draw any long-term conclusions regarding the oncological data.
KW - Cryoablation
KW - Prostate cancer
KW - Radiation therapy
KW - Radical prostatectomy
KW - Salvage surgery
UR - https://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=pmu_pure&SrcAuth=WosAPI&KeyUT=WOS:001310591700004&DestLinkType=FullRecord&DestApp=WOS_CPL
U2 - 10.1007/s00345-024-05199-4
DO - 10.1007/s00345-024-05199-4
M3 - Original Article (Journal)
C2 - 39259304
SN - 0724-4983
VL - 42
JO - WORLD JOURNAL OF UROLOGY
JF - WORLD JOURNAL OF UROLOGY
IS - 1
M1 - 515
ER -