The pattern of prostate cancer local recurrence after radiation and salvage cryoablation

Authors

  • Chee Kwan Ng Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON
  • Naji J. Touma Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON
  • Venu Chalasani Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON
  • Madeleine Moussa Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON
  • Donal B. Downey Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON
  • Joseph L. Chin Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

DOI:

https://doi.org/10.5489/cuaj.748

Abstract

Objective: We assessed the pattern of local recurrence after salvage
cryoablation of the prostate, and the impact of local recurrence on
intermediate-term outcome.

Methods: One hundred twenty-two patients who underwent
salvage cryoablation were studied after a mean follow-up of 56
months. Serial prostate biopsy was carried out after cryoablation.
The histopathology of prostate biopsies before and after cryoablation
were compared. The prognostic value of post-cryoablation
biopsy was assessed with the Cox regression method.

Results: 23.1% of patients had a positive biopsy for prostate cancer
following salvage cryoablation. Most cancer recurrences occurred
in the apex (51.5%), base (21.2%) and seminal vesicles (18.2%).
The presence of cancer at the base of the prostate was found to
be a prognostic factor for eventual biochemical failure. Overall
5-year biochemical disease-free survival (bDFS) was 28%, however
patients with cancer at the base of the prostate had a 5-year
bDFS of 0%.

Conclusion: Cancer recurrences occurred in areas where aggressive
freezing was avoided as it might result in serious problems (e.g.,
urethro-rectal fistula and incontinence). Post-cryoablation biopsies
and the location of persistent disease are of prognostic value.

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Author Biographies

Chee Kwan Ng, Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

Naji J. Touma, Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

Venu Chalasani, Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

Madeleine Moussa, Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

Donal B. Downey, Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

Joseph L. Chin, Division of Urology, Department of Pathology and Department of Radiology, London Health Sciences Centre, University of Western Ontario, London, ON

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How to Cite

Ng, C. K., Touma, N. J., Chalasani, V., Moussa, M., Downey, D. B., & Chin, J. L. (2013). The pattern of prostate cancer local recurrence after radiation and salvage cryoablation. Canadian Urological Association Journal, 5(6), E125-E128. https://doi.org/10.5489/cuaj.748

Issue

Vol. 5 No. 6 (2011): December

Section

Original Research

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