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01-12-2024 | Cryotherapy | Original Article

Nadir prostate-specific antigen after salvage cryotherapy as a potential prognostic factor for oncologic outcomes

Authors: E. Carbonell, C. Mercader, J. Sureda, A. Gutiérrez, J. Muñoz, E. Gallardo, N. Feltes, J. Mases, I. Valduvieco, A. Vilaseca, A. Franco, A. Alcaraz, M. Musquera, M. J. Ribal

Published in: World Journal of Urology | Issue 1/2024

Abstract

Purpose

To report oncologic outcomes of patients undergoing salvage cryotherapy (SCT) for local recurrence of prostate cancer (PCa) and to establish a nadir PSA (nPSA) value that best defines long-term oncologic success.

Methods

Retrospective study of men who underwent SCT for local recurrence of PCa between 2008 and 2020. SCT was performed in men with biochemical recurrence (BCR), after primary treatment and with biopsy-proven PCa local recurrence. Survival analysis with Kaplan–Meier and Cox models was performed. We determined the optimal cutoff nPSA value after SCT that best classifies patients depending on prognosis.

Results

Seventy-seven men who underwent SCT were included. Survival analysis showed a 5-year biochemical recurrence-free survival (BRFS), androgen deprivation therapy-free survival (AFS), and metastasis-free survival (MFS) after SCT of 48.4%, 62% and 81.3% respectively. On multivariable analysis for perioperative variables associated with BCR, initial ISUP, pre-SCT PSA, pre-SCT prostate volume and post-SCT nPSA emerged as variables associated with BCR. The cutoff analysis revealed an nPSA < 0.5 ng/ml to be the optimal threshold that best defines success after SCT. 5-year BRFS for patients achieving an nPSA < 0.5 vs nPSA ≥ 0.5 was 64% and 9.5% respectively (p < 0.001). 5-year AFS for men with nPSA < 0.5 vs ≥ 0.5 was 81.2% and 12.2% (p < 0.001). Improved 5-year MFS for patients who achieved nPSA < 0.5 was also obtained (89.6% vs 60%, p = 0.003).

Conclusion

SCT is a feasible rescue alternative for the local recurrence of PCa. Achieving an nPSA < 0.5 ng/ml after SCT is associated with higher long-term BRFS, AFS and MFS rates.

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Title: Nadir prostate-specific antigen after salvage cryotherapy as a potential prognostic factor for oncologic outcomes
Authors: E. Carbonell
C. Mercader
J. Sureda
A. Gutiérrez
J. Muñoz
E. Gallardo
N. Feltes
J. Mases
I. Valduvieco
A. Vilaseca
A. Franco
A. Alcaraz
M. Musquera
M. J. Ribal
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Keywords: Cryotherapy
Cryotherapy
Prostate Cancer
Prostate Cancer
Brachytherapy
Published in: World Journal of Urology / Issue 1/2024
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-024-04806-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Nadir prostate-specific antigen after salvage cryotherapy as a potential prognostic factor for oncologic outcomes

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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