Hemigland Cryoablation of Localized Low, Intermediate and High Risk Prostate Cancer: Oncologic and Functional Outcomes at 5 Years

No AccessJournal of UrologyAdult Urology1 Dec 2019Hemigland Cryoablation of Localized Low, Intermediate and High Risk Prostate Cancer: Oncologic and Functional Outcomes at 5 YearsThis article is commented on by the following:Editorial Comment Masakatsu Oishi, Inderbir S. Gill, Alessandro Tafuri, Aliasger Shakir, Giovanni E. Cacciamani, Tsuyoshi Iwata, Atsuko Iwata, Akbar Ashrafi, Daniel Park, Jie Cai, Mihir Desai, Osamu Ukimura, Duke K. Bahn, and Andre Luis Abreu Masakatsu OishiMasakatsu Oishi USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California Departments of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan , Inderbir S. GillInderbir S. Gill USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Alessandro TafuriAlessandro Tafuri USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy , Aliasger ShakirAliasger Shakir USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Giovanni E. CacciamaniGiovanni E. Cacciamani USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Tsuyoshi IwataTsuyoshi Iwata USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Atsuko IwataAtsuko Iwata USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Akbar AshrafiAkbar Ashrafi USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Daniel ParkDaniel Park USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Jie CaiJie Cai USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Mihir DesaiMihir Desai USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California , Osamu UkimuraOsamu Ukimura USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California Departments of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan , Duke K. BahnDuke K. Bahn USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California Prostate Institute of America, Community Memorial Hospital, Ventura, California , and Andre Luis AbreuAndre Luis Abreu *Correspondence: 1441 Eastlake Ave., Suite 7416, Los Angeles, California 90089 telephone: 323-865-3700; E-mail Address: [email protected] USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California View All Author Informationhttps://doi.org/10.1097/JU.0000000000000456AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated 5-year oncologic and functional outcomes of hemigland cryoablation of localized prostate cancer. Materials and Methods: We reviewed the records of 160 consecutive men who underwent hemigland cryoablation of localized prostate cancer. Recurrent and/or residual clinically significant prostate cancer was defined as Grade Group 2 or greater on followup biopsy. A prostate specific antigen nadir plus 2 ng/ml according to the Phoenix criteria was used to define biochemical failure. Radical treatment was defined as any whole gland therapy. Treatment failure was defined as any radical and/or whole gland treatment, systemic therapy initiation, metastasis or prostate cancer specific mortality. The study primary end point was treatment failure-free survival. The secondary end points were survival free of biochemical failure, clinically significant prostate cancer and radical treatment. Followup biopsy and functional outcomes were also evaluated. Statistical analysis included the Kaplan-Meier method, and univariate and multivariable Cox and logistic regression with significance considered at p <0.05. Results: Median patient age was 67 years, baseline prostate specific antigen was 6.3 ng/ml and followup was 40 months. A total of 131 patients (82%) had D'Amico intermediate (66%) or high risk (16%) prostate cancer. At 5 years the treatment failure-free survival rate was 85%, the biochemical failure-free survival rate was 62% and the survival rate free of clinically significant prostate cancer was 89%. Higher baseline prostate specific antigen independently predicted treatment failure (p <0.001), biochemical failure (p=0.048), recurrence and radical treatment (p <0.01). Grade Group 3 or greater independently predicted treatment failure (p=0.04). The metastasis-free survival rate was 100% at 5 years. Pad-free continence and potency (erections sufficient for intercourse) were retained in 97% and 73% of patients, respectively. 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No direct or indirect commercial, personal, academic, political, religious or ethical incentive is associated with publishing this article. © 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLabbate C, Klotz L, Morrow M, Cooperberg M, Esserman L and Eggener S (2022) Focal Therapy for Prostate Cancer: Evolutionary Parallels to Breast Cancer TreatmentJournal of Urology, VOL. 209, NO. 1, (49-57), Online publication date: 1-Jan-2023.Tafuri A, Iwata A, Shakir A, Iwata T, Gupta C, Sali A, Sugano D, Mahdi A, Cacciamani G, Kaneko M, Cai J, Ukimura O, Duddalwar V, Aron M, Gill I, Palmer S and Abreu A (2021) Systematic Biopsy of the Prostate can Be Omitted in Men with PI-RADS™ 5 and Prostate Specific Antigen Density Greater than 15%Journal of Urology, VOL. 206, NO. 2, (289-297), Online publication date: 1-Aug-2021.Chuang R, Kinnaird A, Kwan L, Sisk A, Barsa D, Felker E, Delfin M and Marks L (2020) Hemigland Cryoablation of Clinically Significant Prostate Cancer: Intermediate-Term Followup via Magnetic Resonance Imaging Guided BiopsyJournal of Urology, VOL. 204, NO. 5, (941-949), Online publication date: 1-Nov-2020.Abreu A, Peretsman S, Iwata A, Shakir A, Iwata T, Brooks J, Tafuri A, Ashrafi A, Park D, Cacciamani G, Kaneko M, Duddalwar V, Aron M, Palmer S and Gill I (2020) High Intensity Focused Ultrasound Hemigland Ablation for Prostate Cancer: Initial Outcomes of a United States SeriesJournal of Urology, VOL. 204, NO. 4, (741-747), Online publication date: 1-Oct-2020.Perlis N (2019) Editorial CommentJournal of Urology, VOL. 203, NO. 2, (329-329), Online publication date: 1-Feb-2020.Smith J (2019) This Month in Adult UrologyJournal of Urology, VOL. 202, NO. 6, (1069-1070), Online publication date: 1-Dec-2019.Related articlesJournal of Urology16 Sep 2019Editorial Comment Volume 202Issue 6December 2019Page: 1188-1198Supplementary Materials Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.Keywordsriskprostatic neoplasmstreatment failureprostate specific antigencryosurgeryMetricsAuthor Information Masakatsu Oishi USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California Departments of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan More articles by this author Inderbir S. Gill USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Alessandro Tafuri USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California University of Verona, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy More articles by this author Aliasger Shakir USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Giovanni E. Cacciamani USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Tsuyoshi Iwata USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Atsuko Iwata USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Akbar Ashrafi USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Daniel Park USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Jie Cai USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Mihir Desai USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California More articles by this author Osamu Ukimura USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California Departments of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan More articles by this author Duke K. Bahn USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California Prostate Institute of America, Community Memorial Hospital, Ventura, California More articles by this author Andre Luis Abreu USC Institute of Urology and Catherine and Joseph Aresty Department of Urology, Keck School of Medicine, University of Southern California, Los Angeles, California *Correspondence: 1441 Eastlake Ave., Suite 7416, Los Angeles, California 90089 telephone: 323-865-3700; E-mail Address: [email protected] More articles by this author Expand All The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number. 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