Salvage cryoablation: Feasible option after radiotherapy

Cryoablation is a feasible treatment option in patients who have failed radiotherapy, especially in those who may not be considered suitable surgical candidates for salvage radical prostatectomy, according to a new study.

Joseph L. Chin, MD, of the University of Western Ontario, London, Canada, and colleagues assessed the feasibility and efficacy of cryoablation for a mean of 39 months in 187 men who had failed definitive radiotherapy for prostate cancer. These patients had local recurrence of prostate cancer and no clinical evidence of distant metastases.

Patients with low PSA before cryoablation (less than 4.0 ng/mL) had a 5-year biochemical recurrence-free survival of 56% and an 8-year biochemical recurrence-free survival of 37%. In contrast, patients with high PSA (ie, greater than 10.0 ng/mL) had a 5-year biochemical recurrence-free survival of only 14% and 8-year recurrence-free survival of 7%. As expected, patients with PSA in the 4.0 ng/mL to 10.0 ng/mL range had an intermediate survival outcome.

Overall, 5- and 8-year survivals for the entire group were 97% and 92%, respectively. The researchers also found that the best candidates for salvage cryoablation appear to be those patients with low PSA levels: less than 4.0 ng/mL at the time of cryoablation.