Focal vs Total PCa Cryoablation Better for Sexual Function

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Oncologic outcomes are similar for focal and total cryoablation for localized prostate cancer, but patients report significantly better sexual function after focal cryoablation.
Oncologic outcomes are similar for focal and total cryoablation for localized prostate cancer, but patients report significantly better sexual function after focal cryoablation.
The following article is part of conference coverage from the 2018 American Urological Association meeting in San Francisco. Renal and Urology News' staff will be reporting live on medical studies conducted by urologists and other specialists who are tops in their field in kidney stones, prostate cancer, kidney cancer, bladder cancer, enlarged prostate, and more. Check back for the latest news from AUA 2018. 

SAN FRANCISCO—Focal cryoablation for organ-confined prostate cancer (PCa) is associated with similar oncologic control to that of total cryoablation, but superior sexual function during the 4 years following treatment, researchers reported at the American Urological Association 2018 annual meeting.

Glenn Werneburg, PhD, of Stony Brook University, Aaron Katz, MD, of NYU Winthrop Hospital, and colleagues studied 102 PCa patients who underwent total cryoablation and 195 who underwent focal cryoablation at NYU Winthrop. By Kaplan-Meier estimate, the 6-year rates of biochemical recurrence-free survival and 8-year freedom from post-treatment positive biopsy were 40% and 65%, respectively, in the total cryotherapy group and 39% and 58% in the focal cryotherapy group. The between-group differences in rates were not significant.

The group included in their analysis the responses to 335 EPIC quality-of-life questionnaires from 38 patients in the total cryotherapy group and 89 patients in the focal cryotherapy group during the 4 years following treatment. The groups did not differ significantly with respect to post-procedural urinary function or bowel habits, but the focal cryotherapy group reported significantly higher sexual function scores compared with the total cryotherapy group over the 4 years following the procedure (+17 points mean difference in EPIC sexual function domain scores, p<0.001).

“Both focal and total cryoablation patients reported similar sexual function scores relative to our active surveillance group by the fourth postoperative year,” Dr Werneburg told Renal & Urology News. “In low-risk prostate cancer patients, active surveillance is an effective management option, and, importantly, our data show that quality of life scores in this cohort remain relatively stable.”

The total and focal cryotherapy groups had a median age of 72 years and 67 years, respectively. The proportion of white patients in these groups was 78.3% and 74.2%, respectively. Patients who underwent cryotherapy had higher pre-treatment Gleason scores than those who underwent focal cryoablation, consistent with the selection criteria for focal cryotherapy.

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Reference

Werneburg GT, Kongnyuy M, Halpern D, et al. Focal cryoablation is associated with superior quality of life and no difference in disease control relative to total cryoablation in prostate cancer patients. Data presented in poster format at the American Urological Association 2018 annual meeting, San Francisco, May 18–21. Abstract MP30-12.

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