Comparison of Outcomes Between Preoperatively Potent XXXX Treated with Focal Versus Whole Gland Cryotherapy in a Matched Population.

@entity1 @entity5 @entity628 @entity15531 @entity292 @entity1486
BACKGROUND AND PURPOSE: The refinement in the localization of prostate @entity5 @entity5 foci through transperineal template-mapping biopsies and MRI has led to an increased interest in lesion-directed focal prostatic cryoablation. Data are lacking, however, that compare the outcomes of @entity15531 ( @entity15531 ) to @entity628 ( @entity628 ). The aim of our study was to assess both oncologic and functional outcomes between @entity15531 and @entity628 cryoablation of the prostate after having matched @entity1 for preoperative characteristics. @entity1 AND METHODS: We matched with a 1:1 ratio 317 @entity1 who underwent @entity628 with 317 who underwent @entity15531 treatment in the Cryo Online Data (COLD) registry between 2007 and 2013. All @entity1 were low-risk according to the D'Amico risk groups and were matched according to age at surgery. We only included preoperatively potent @entity1 . Oncologic outcomes were biochemical recurrence (BCR) free-survival defined according to the American Society for Radiation Oncology (ASTRO) and Phoenix criteria and assessed by Kaplan-Meier curves. Only @entity1 with @entity1486 (PSA) nadir data were included in oncologic outcome analysis. Functional outcomes were assessed at 6, 12, and 24 months after the procedure for erectile function (defined as ability to have intercourse with or without erectile aids), urinary continence, urinary retention, and rates of @entity292 formation. RESULTS: Median age at the time of the procedure was 66.5 years (standard deviation [SD] 6.6   y), and median follow-up time was 58.3 months. After surgery, 30% (n=95) and 17% (n=55) of the @entity1 who received @entity15531 and @entity628 , respectively, underwent biopsy, with positive biopsy rates of 11.6% and 14.5%, respectively. BCR-free survival rates at 60 months according to the Phoenix definition were 80.1% and 71.3% in the @entity15531 and @entity628 cohorts, respectively, with a hazard ratio of 0.827; according to the ASTRO definition, they were 82.1% and 73%, respectively (all P >=  0.1). Erectile function data at 24 months was available for 172 @entity15531 and 160 @entity628 treated @entity1 . Recovery of erection was achieved in 46.8% and 68.8% of @entity1 in the @entity15531 and @entity628 cohorts, respectively (P=0.001). Urinary function data at 24 months was available for 307 @entity15531 and 313 @entity628 @entity1 . Continence rates were 98.7% and 100% for @entity15531 and @entity628 groups, respectively (P=0.02). Urinary retention at 6, 12, and 24 months was reported in 7.3%, 1.9%, and 0.6%, respectively, in the @entity15531 arm, and in 5%, 1.3%, and 0.9%, respectively, in the @entity628 arm. Finally, only one @entity292 was reported in each group. CONCLUSIONS: @entity1 with low-risk prostate @entity5 who underwent @entity628 cryoablation had comparable BCR-survival rates at 60 months to @entity1 treated with @entity15531 . However, @entity628 @entity1 had higher erectile function preservation rates at 24 months post-procedure. Urinary continence, retention and @entity292 rates were similar between the two treatment groups.
