Comparing cryosurgery and hormonal therapy for locally recurrent prostate cancer after radiotherapy

This study compared local cryosurgery (CRYO) against androgen deprivation therapy (ADT) for the treatment of locally recurring prostate cancer (LRPC). The study found local cryosurgery had a longer overall survival (OS) when compared to ADT.

LRPC is cancer that has re-occurred in the prostate gland after treatment. First treatment for prostate cancer (PC) often involves radiotherapy (RT). Optimal management of isolated LRPC after RT has not been defined.

ADT is commonly used as a treatment for LRPC. However, it is associated with side effects that may negatively impact the quality of life (QOL). CRYO involves using very cold temperatures to freeze and kill prostate cancer cells. CRYO can also be used in LRPC after RT. It was unknown if ADT or CRYO are associated with better outcomes for patients with LRPC.

This study included 338 patients with LRPC. All patients had been treated before with RT. Half of the patients then received CRYO. They were followed up for an average of 18.65 years. The other half received ADT. They were followed up for an average of 6.73 years. 

The average overall survival (OS) was 12.33 years for the CRYO group. The average OS was 10.17 years for the ADT group. Patients who received CRYO were 31% more likely to have a longer OS compared to the ADT group. Overall, the prostate cancer-specific mortality was not significantly different between the 2 treatments.

The authors concluded that local cryosurgery was associated with a longer overall survival when compared to ADT for PC relapsing after RT. 

This study was based on medical records data. Some information might have been missing. this might have affected the results. Also, the study did not measure QOL or side effects. Further controlled studies are needed for stronger evidence.