Salvage cryo after RT shows long-term efficacy in some prostate cancers

May 19, 2008

Salvage cryotherapy for locally recurrent prostate cancer following primary radiotherapy is curative in approximately one-third of men after 10 years of follow-up, according to results of a retrospective chart review investigating long-term treatment outcomes.

Salvage cryotherapy for locally recurrent prostate cancer following primary radiotherapy is curative in approximatelyone-third of men after 10 years of follow-up, according to results of a retrospective chart review investigating long-termtreatment outcomes.

The study, from the University of South Florida, Tampa, included 110 patients who had been treated with salvage cryotherapy atthe University of Texas M.D. Anderson Cancer Center, Houston. All had biopsy-proven locally recurrent prostate cancer and werefollowed every 3 months with determination of serum PSA. The median follow-up after salvage cryotherapy was 7.9 years.

Biochemical failure, defined as a serum PSA >0.5 ng/mL, was analyzed as the primary endpoint of the study. By 1 year, thebiochemical failure rate was already high at 58%. At 5 years, it reached 74%, but then increased only slightly to 83% at 10years. Disease-specific survival rates for this population were 87% at 5 years and 63% at 10 years.

"The management of men with locally recurrent prostate cancer after primary radiation therapy represents a clinicalchallenge," said Omar Hamoui, MD, the study's first author. "Cryotherapy is one treatment option, but there has been limitedinformation in the literature about its long-term outcomes.

"Our study is distinguished from existing reports by the length of our follow-up, and we believe our long-term results supportthe clinical utility of salvage cryotherapy for this patient population."

"While these results suggest that cryotherapy is a feasible treatment option for men with locally recurrent prostate cancerafter primary radiation therapy, based on a comparison with historical data, cryotherapy remains inferior to salvageprostatectomy," added lead author Philippe E. Spiess, MD. "However, our data on biochemical failure rates indicate that PSAmonitoring can be used to determine at an early stage patients who are going to fail. At that time, they can be considered forother treatment, such as hormonal ablative therapy or chemotherapy."