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. PATIENTS AND 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%). CONCLUSION: Salvage TCAP is a safe and effective treatment for localized prostate cancer recurrence after radiotherapy.