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


Journal

World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716

Informations de publication

Date de publication:
11 Sep 2024
Historique:
received: 08 05 2024
accepted: 30 07 2024
medline: 11 9 2024
pubmed: 11 9 2024
entrez: 11 9 2024
Statut: epublish

Résumé

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. 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. 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. 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.

Identifiants

pubmed: 39259304
doi: 10.1007/s00345-024-05199-4
pii: 10.1007/s00345-024-05199-4
doi:

Substances chimiques

Prostate-Specific Antigen EC 3.4.21.77

Types de publication

Journal Article Comparative Study Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

515

Informations de copyright

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Références

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Auteurs

Juan Gomez Rivas (JG)

Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain.

Mark Taratkin (M)

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Camilla Azilgareeva (C)

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Andrey Morozov (A)

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.

Silvia Laso (S)

Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain.

Dmitry Enikeev (D)

Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.
Department of Urology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria.
Division of Urology, Rabin Medical Center, Petah Tikva, Israel.

Jesús Moreno Sierra (JM)

Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain.

Ksenia Schelkunova (K)

Institute for Clinical Medicine, Sechenov University, Moscow, Russia.

Francesco Sanguedolce (F)

Department of Urology, Fundació Pugivert, Barcelona, Spain.

Alberto Breda (A)

Department of Urology, Fundació Pugivert, Barcelona, Spain.

Alexander Govorov (A)

Moscow State University of Medicine and Dentistry, Moscow, Russia.

Alexander Vasilyev (A)

Moscow State University of Medicine and Dentistry, Moscow, Russia.

Marcos Cepeda (M)

Department of Urology, Hospital Rio Ortega, Valladolid, Spain.

Lukas Lusuardi (L)

Department of Urology and Andrology, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.

Maximilian Pallauf (M)

Department of Urology and Andrology, Paracelsus Medizinische Privatuniversität, Salzburg, Austria.

Antonio Celia (A)

Department of Urology, San Bassiano Hospital, Bassiano del Grappa, Italy.

Tommaso Silvestri (T)

Department of Urology, San Bassiano Hospital, Bassiano del Grappa, Italy.

Cristian Fiori (C)

Department of Urology, San Luigi Gonzaga Hospital, University of Turin, Turin, Italy.

Esaú Fernández (E)

Lyx Institute of Urology, Madrid, Spain.

Juan Ignacio Martínez-Salamanca (JI)

Lyx Institute of Urology, Madrid, Spain.

Eric Barret (E)

Department of Urology, Institut Mutualiste Montsouris, 42 boulevard Jourdan, Paris, 75014, France. Eric.Barret@imm.fr.

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