Salvage cryotherapy for recurrent prostate cancer after radiation failure: a prospective case series of the first 100 patients.
OBJECTIVE
To report the short- to intermediate-term experience of using salvage targeted cryoablation of the prostate (TCAP) for the recurrence of localized prostate cancer after radiotherapy.


METHODS
Between May 2000 and November 2005, 100 patients had salvage TCAP for recurrent prostate cancer after radiotherapy; the mean follow-up was 33.5 months. All patients had biopsy-confirmed recurrent prostate cancer. Biochemical recurrence-free survival (BRFS) was defined using a prostate specific antigen (PSA) level of <0.5 ng/mL and by applying the American Society for Therapeutic Radiology and Oncology (ASTRO) definition for biochemical failure. Patients were stratified into three risk groups, i.e. high-risk (68 men), intermediate-risk (20) and low-risk (12).


RESULTS
There were no operative or cancer-related deaths; the 5-year actuarial BRFS was 73%, 45% and 11% for the low-, intermediate- and high-risk groups, respectively. Complications included incontinence (13%), erectile dysfunction (86%), lower urinary tract symptoms (16%), prolonged perineal pain (4%), urinary retention (2%), and recto-urethral fistula (1%).


CONCLUSIONS
Salvage TCAP is a safe and effective treatment for localized prostate cancer recurrence after radiotherapy.
The Royal Surrey County Hospital and St Luke's Cancer Centre, Guildford, Surrey, UK. ms18273@gmail.com
Mohamed
M
Ismail
Shwan
S
Ahmed
Christof
C
Kastner
John
J
Davies
D000368:Aged; D003452:Cryosurgery; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen