Prostate Cancer Salvage Cryotherapy Potentially Curative

Salvage cryotherapy is potentially curative in patients with locally recurrent prostate cancer (PCa) after primary radiation treatment, according to a new study.

Philippe E. Spiess, MD, of the Moffitt Cancer Center in Tampa, Fla., and colleagues found that these patients had one-, two-, and three-year biochemical disease-free survival (bDFS) rates of 89.0%, 73.7%, and 66.7%, respectively. They also found that early referral for salvage treatment is associated with improved bDFS.  The three-year bDFS rate was 78.3% for patients with a pre-salvage PSA level below 5 ng/mL compared with 52.9% for those who had a pre-salvage PSA level of 5 ng/mL or higher, Dr. Spiess' team reported online ahead of print in the World Journal of Urology.

The mean time to biochemical failure—defined as nadir PSA plus 2 ng/mL—among patients with a pre-salvage PSA level below 5 ng/mL (85 patients) and 5 ng/mL or more (71 patients) was 30.3 and 18.4 months, respectively.

The study's 156 patients—who are included in the COLD (cryo online data) Registry—underwent salvage radiotherapy without neoadjuvant hormone ablative therapy. Subjects had a mean follow-up of 3.8 years.

Dr. Spiess and his colleagues said it is evident that patients with a pre-salvage PSA level below 5 ng/mL “do far better” than those with a PSA level of 5 ng/mL or higher. They noted that their results “are particularly impactful” because the two subgroups were matched in terms of their other clinical and pathologic characteristics, thus “minimizing any potential impact confounding variables could have had on our findings.”

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