Salvage Radical Prostatectomy, Cryotherapy Viable Options for Recurrent Prostate Cancer: Presented at EAU

By Chris Berrie

BARCELONA, Spain -- March 21, 2019 -- The local treatment approaches of salvage radical prostatectomy and salvage cryotherapy can provide similar durable long-term cancer-specific survival for men with recurrent localised prostate cancer, according to a study presented here at the 34th Annual European Association of Urology (EAU) Congress.

Approximately half of the men with primary prostate cancer who undergo radical external-beam radiotherapy show localised disease recurrence. Although identification of these men accurately can be difficult, they are particular candidates for local salvage therapy, which is potentially curative, noted Shiva Nair, MD, PhD, Division of Urology, London Health Sciences Centre, Western University, London, Ontario.

Because salvage radical prostatectomy and salvage cryotherapy are 2 such local treatment approaches, the researchers designed this large cohort comparative analysis across 2 specialist centres with prospectively recorded data to evaluate long-term outcomes.

At baseline, patients in the prostatectomy (n = 251) and cryotherapy (n = 187) cohorts differed significantly in median age (67 vs 71 years; P< .0001) and presalvage prostate-specific antigen (PSA) levels (3.8 vs 4.9 ng/mL; P< .0005). However, Gleason scores were similar.

At a median follow-up of 118 and 105 months, respectively, 272 of the men had experienced biochemical recurrence (PSA >0.4 ng/mL; 139 vs 133), 108 had developed metastases (70 vs 38), and 247 had died (116 vs131). Of the deaths, 36% (50 vs 39) were due to prostate cancer.

The biochemical recurrence-free survival was significantly better with the prostatectomy approach (log-rank P = .0012), although cancer-specific survival was similar in the 2 approaches (log-rank P = .0556). Metastases and overall survival rates were also similar in the groups.

The researchers concluded that durable long-term survival was achieved by these local salvage treatments, whereby they both represent viable options for local treatment of radiorecurrent prostate cancer.

They noted that careful patient selection is critical in the decision-making process for salvage therapy.

[Presentation title: Salvage Cryotherapy Versus Salvage Radical Prostatectomy for Radiorecurrent Prostate Cancer: Long-Term Oncological Outcomes. Abstract 654]

To read more Conference Dispatch articles, click here.