Prostate Cancer: LocalizedModerated Poster 53: Tuesday, May 17, 2011: 10:30 AM-12:30 PM1639 ACHIEVING THE “TRIFECTA” USING FOCAL CRYOTHERAPY AS A PRIMARY TREATMENT FOR PROSTATE CANCER: COLD REGISTRY DATA
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INTRODUCTION AND OBJECTIVES
In the present study, we evaluate the ability to achieve the therapeutic “trifecta” with focal cryotherapy using the COLD (Cryo On-Line Data) Registry. Focal cryotherapy was conducted using various templates of cryoablation. The “trifecta” being defined as (post-treatment): (1) achieving a nadir serum PSA < 0.6 ng/ml based on publication suggesting this surrogate, (2) no urinary incontinence, and (3) ability to have sexual intercourse (with or without intervention).
METHODS
A prospectively, centrally collected secure online database has been developed of patients undergoing focal cryoablation (using various partial gland templates) for localized prostate cancer. Of the 1214 patients undergoing focal cryotherapy which are included within the COLD Registry, complete medical records pertaining to continence status, ability to maintain sexual activity, and serial PSA measurements post-treatment were available in 308 patients, with the therapeutic “trifecta” achieved
RESULTS
Of the patient achieving the “trifecta”, the mean age at presentation was 65.9 years (+/− 8.0 years). The majority of patients had a baseline PSA < 10 ng/m, a clinical stage < T2b, and a biopsy Gleason score < 8 (85%, 84%, and 95%; respectively). The 1, 2, and 5 year actuarial biochemical failure rates using the Phoenix definition (nadir + 2 ng/ml) were 96.2%, 95.0%, and 93.2%, respectively. Following focal cryotherapy, urinary retention occurred in 3 (1.9%) and urethral fistulas in 1 (0.6%) of
CONCLUSIONS
Focal cryotherapy has been evaluated as a potential treatment choice for well selected patients in an attempt to minimize morbidity without compromising oncological outcome in patients with low volume disease. The present study highlights that only 51% of patients achieved the therapeutic “trifecta” raising into question its true benefit over established treatment choices for localized prostate cancer. We do acknowledge however that the templates of focal cryoablation varied significantly
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Source of Funding: The COLD Registry is sponsored by an unrestricted research grant from Endocare. Data are held and analyzed by Watermark, an independent research company under the direction of an independent physician board.