COMPARISION OF EARLY ONCOLOGIC OUTCOMES OF FOCAL CRYOTHERAPY IN UNILATERAL, ORGAN CONFINED PROSTATE CANCER (PCA) WITH GLEASON SCORE 6(3+3) VS 7(3+4)
Introduction and Objectives:
To compare the perioperative and oncologic outcomes of Focal Cryotherapy (FC) in unilateral, organ confined prostate cancer (PCa) with Gleason score (GS) 6 Vs GS 7(3+4)
Materials and Methods:
We analyzed 108 patients who underwent primary FC - hemiablation at our institution (March 2009 - February 2014). Cancer localization was done with transrectal ultrasound (TRUS) guided prostate biopsy and Magnetic Resonance Imaging (MRI). Under general anesthesia, FC was delivered through transperineal needles placed in the affected lobe with TRUS guidance. Follow-up constitutes of Prostate Specific Antigen (PSA) every 3 months and MRI and control biopsy at 12 months. Biochemical recurrence (BCR) was defined using Phoenix criteria (PSA NADIR + 2ng/dl) and positive biopsy in the treated area was considered recurrence. We compared the perioperative and oncologic outcomes following FC in patients with GS6 Vs GS 7(3+4) at initial TRUS biopsy. The complications were reported using the Clavien-Dindo classification.
We found 82 patients with GS 6 and 21 with GS 7 (3+4). Clinical and operative characteristics were similar (Table 1). The mean follow up was 26.7 (±16.9) months. There was no significant difference noted between GS6 vs GS7 in the biopsy recurrence (24% vs 38%, p=0.3) and BCR rates. There were 20 complications in 14 (13.5%) patients. All were low grade, except two patients who had III b complications (table 2)
The perioperative and oncologic outcomes of FC - Hemiablation for unilateral, organ confined PCa appears to similar between GS6 and GS7 (3+4) disease.