Focal Cryotherapy in the Treatment of Localized Prostate Cancer: Early Outcomes
Taimur T. Shah1-3, Benjamin Thomas1, Massimo Valerio1,2, Maneesh Ghei1, 3, Hashim U. Ahmed1,2, Manit Arya1,2,4
3. Department of Urology, Whittington Hospital, London 4. Derpartment of Urology, Princess Alexandra NHS Trust, Harlow
Focal cryotherapy may offer good short-medium term oncological outcomes with minimal side-effects. We recently started a focal cryotherapy program and created a prospective registry to monitor safety, adverse-events, functional outcomes and disease control.
All patients undergoing focal cryotherapy had their clinical and patient reported outcome data (IPSS, EPIC, IIEF-15) collected prospectively, pre-operatively and for up to 1 year post-operatively.
All patients had their diagnosis made by either transperineal template or mpMRI targeted biopsies.
Left – Diffusion Weighted (DWI) multi-parametric MRI showing restricted diffusion of a left anterior lesion
Middle - All procedures were performed using the SeedNet system (Galil Medical) with intraoperative US monitoring of the ice ball.
Right – Post- operative dynamic contrast enhanced (DCE) image showing no enhancement of treated area.
Between October 2013 and January 2015, 37 patients underwent primary focal cryotherapy and 13 underwent salvage treatment.
Other adverse-events occurred in 11/50 patients (22%): 6 AURs, 5 UTI’s, 1 haematuria and 1 penile-tip numbness.
Our early oncological outcomes show a greater than 80% drop in PSA with a biochemical failure rate of 0% and a 0% re-treatment rate.
Our early results show minimal side-effects conferred by focal cryotherapy. Continued follow-up will determine the medium to long-term disease control.