Whole and hemi-gland cryoablation for primary localized prostate cancer: Short and medium-term oncological and functional outcomes.
INTRODUCTION
To compare oncological, functional and post-operative outcomes of hemi (HC) vs. whole gland (WGC) cryoablation as first line treatment of localized prostate cancer.


MATERIAL AND METHOD
Sixty-six consecutive patients undertaking whole-gland cryoablation (WGC=40) or hemi-cryoablation (HC=26) in a tertiary referral centre between 2010 and 2018 were included. All patients had a low-intermediate risk prostate cancer according to D'Amico risk classification. Hemi-ablation was proposed in case of biopsy and prostate MRI proven unilateral prostate cancer. Primary endpoint was Cryotherapy Failure for which 3 definitions were considered and compared: 1) biochemical failure (> PSA nadir+≥ 2 ng/mL), 2) positive prostate re-biopsy with Gleason score ≥ 7, 3) initiation of further prostate cancer treatment.


RESULTS
Median patients age at treatment was 74 [42-81] vs. 76 [71-80] years in WGC vs. HC group, respectively (p=.08). Low and intermediate D'Amico risk group were 15% and 85% vs. 23% and 77% (p=.75), respectively. Median follow- up time was 41 [1.5-99.0] vs. 27 [0.9-93] months (p=.03). Four-years cryotherapy failure free survival in WGC vs. HC were 69% vs. 53% with definition 1 (p=.24), 82% vs. 80% with definition 2 (p=.95), 83% vs. 77% with definition 3 (p=.73). Early and 1-year urinary continence were 60% and 83% in WGC vs. 72% and 83% in HC (p=.26). De novo impotency after cryotherapy was 75% vs. 46% (p=.33) in WGC vs. HC.


CONCLUSIONS
In our cohort of highly selected patients with unilateral low/intermediate risk PCa, hemi-cryoablation may provide similar oncological outcomes and less early complications compared to whole-gland cryoablation.
['Bossier|R|R|', 'Sanguedolce|F|F|', 'Territo|A|A|', 'Vanacore|D|D|', 'Martínez|C|C|', 'Regis|F|F|', 'Gallioli|A|A|', 'Mercade|A|A|', 'Mosquera|L|L|', 'Aumatell|J|J|', 'Balana|J|J|', 'Carlderon|J|J|', 'Huguet|J|J|', 'Gaya|J M|JM|', 'Palou|J|J|', 'Breda|A|A|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D003452:Cryosurgery D006801:Humans D008297:Male D008875:Middle Aged D011468:Prostatectomy D011471:Prostatic Neoplasms D012189:Retrospective Studies D013997:Time Factors D016896:Treatment Outcome
Prostate cancer Cryotherapy Crioterapia Cáncer de próstata Focal treatment Tratamiento focal