In a nutshell
This study looked at the use of focal cryotherapy (FC) for the treatment of low- to intermediate-risk prostate cancer (PC). The authors found that the use of FC was safe and increased time to further therapy with similar survival compared to active surveillance (AS).
PC is one of the most common forms of cancer found in men. In the early stages, PC is usually treated with AS. This involves closely monitoring the patients with tests without giving any treatment. More advanced stages of PC are usually treated with hormonal therapy or radical treatments such as radiation therapy or surgery. However, these treatments often have side effects that reduce patients' quality of life.
Other options for treating low- and intermediate-risk PC are focal therapies. These involve non-invasive methods that only destroy the tumor, leaving the rest of the prostate gland unharmed. FC is a focal therapy that involves destroying cancer cells by freezing them. Medium-term studies have shown good outcomes with this treatment, with minimal side effects. However, long-term results of FC and comparison to AS in patients with low- to intermediate-risk PC are still missing.
Methods & findings
This trial involved 580 patients with PC. 121 patients underwent FC. 459 patients underwent AS. The average follow-up was 85 months for the FC group.
Overall, 55.4% of patients in the FC group did not undergo additional retreatment. The spread of PC to other sites around the body was rare and occurred in 4.1% of patients who had FC. After 5 years, 70.5% were treatment-free and hormone therapy-free. After 10 years, this rate was 51%. After 10 years, 97% of patients who had FC were alive and 93.9% did not have any metastasis.
35 men (26.5%) in the FC group had complications. These included urine leakage and erectile dysfunction.
In the AS group, time to any treatment, including radical or hormonal treatments was significantly shorter compared to the FC group. However, other survival or metastasis-free survival rates were not different between groups.
The bottom line
The authors found that FC was safe and effective but did not offer significant advantages over AS for low-risk PC. The authors recommend AS over FC in these patients.
The fine print
This study included data from medical records. Further randomized studies are needed for more conclusive results.
Published By :
European urology focus
Apr 26, 2021
If you sign up for Medivizor, you'll receive PERSONALIZED updates that are JUST FOR YOU. Want to give it a try?