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    Focal, whole-gland cryo yield similar cancer control

    But recovery of erectile function is better with focal technique, data show

    New Orleans—Among men who are potent and have low-risk prostate cancer, focal cryotherapy appears to deliver similar oncologic control but with much better recovery of erectile function than a whole-gland approach, according to an analysis using data from the Cryo On-Line Data (COLD) Registry.     

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    The retrospective study was presented at the AUA annual meeting in New Orleans. It included 317 men who underwent focal cryotherapy and 317 age-matched men who had whole-gland cryotherapy between 2007 and 2013. Men were selected for inclusion in the study if they had low-risk prostate cancer (Gleason score ≤6, initial PSA <10.0 ng/mL, and <cT2b) and were potent prior to treatment.

    Oncologic outcome was assessed based on biochemical recurrence (BCR) using Phoenix criteria. At 60 months, the Kaplan-Meier estimated BCR-free survival rate for the focal group was non-inferior to that for the men treated with a whole-gland approach (80.1% vs. 71.3%, respectively; hazards ratio 0.827, p=.5), reported first author Melissa Mendez, MD, clinical research fellow at Duke Cancer Institute, Durham, NC.

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    Functional outcomes were evaluated at 24 months. At that time, there were almost no men in the focal and whole-gland groups with urinary retention (0.9% and 0.6%, respectively) or urinary incontinence (0% and 1.3%, respectively), and there was a single man in each group who had a fistula. However, the rate of preservation of erectile function was significantly higher among men who had focal cryotherapy than in the whole-gland group: 69% versus 47%, respectively.

    “Future validation studies are needed to evaluate the long-term oncological outcomes for these procedures in comparison with prostatectomy and radiation therapy. Another important next step will be to contemporize the patient population to include intermediate-risk disease as low-risk prostate cancer patients are now more commonly referred to active surveillance,” said Dr. Mendez, who worked on the study with J. Stephen Jones, MD, and co-authors from Cleveland Clinic, Moffitt Cancer Center in Tampa, FL, and Duke.

    NEXT: Focal cryo 'could be an attractive option'

    Cheryl Guttman Krader
    Cheryl Guttman Krader is a contributor to Dermatology Times, Ophthalmology Times, and Urology Times.


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