Cryotherapy versus radical prostatectomy as a salvage treatment for radio-recurrent prostate cancer

• Published in: World journal of urology 2024-09, Vol.42 (1), p.515, Article 515
• Main Authors: Rivas, Juan Gomez, Taratkin, Mark, Azilgareeva, Camilla, Morozov, Andrey, Laso, Silvia, Enikeev, Dmitry, Sierra, Jesús Moreno, Schelkunova, Ksenia, Sanguedolce, Francesco, Breda, Alberto, Govorov, Alexander, Vasilyev, Alexander, Cepeda, Marcos, Lusuardi, Lukas, Pallauf, Maximilian, Celia, Antonio, Silvestri, Tommaso, Fiori, Cristian, Fernández, Esaú, Martínez-Salamanca, Juan Ignacio, Barret, Eric
• Format: Article
• Language: English
• Subjects: Aged; Comparative analysis; Cryosurgery - methods; Cryotherapy; Cryotherapy - methods; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Morbidity; Neoplasm Recurrence, Local; Nephrology; Oncology; Prostate cancer; Prostate-Specific Antigen - blood; Prostatectomy; Prostatectomy - methods; Prostatic Neoplasms - radiotherapy; Prostatic Neoplasms - surgery; Radiation therapy; Retrospective Studies; Salvage Therapy - methods; Survival; Treatment Outcome; Urology
• ISSN: 1433-8726; 0724-4983; 1433-8726
• DOI: 10.1007/s00345-024-05199-4

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  0.05). 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.