Treatment of localized prostate cancer in elderly patients: the role of partial cryoablation

Purpose To evaluate oncological outcomes of partial gland cryoablation (PGC) for localized prostate cancer (PCa) in a cohort of elderly patients who required an active treatment.

Methods Data from 110 consecutive patients treated with PGC for localized PCa were collected.

All patients underwent the same standardized follow-up with serum-PSA level and digital rectal examination.

Prostate MRI and eventual re-biopsy were performed at twelve months after cryotherapy or in case of suspicion of recurrence.

Biochemical recurrence was defined according to Phoenix criteria (PSA nadir + 2 ng/ml).

Kaplan–Meier curves and Multivariable Cox Regression analyses were used to predict disease progression, biochemical recurrence- (BCS) and additional treatment-free survival (TFS).

Results Median age was 75 years (IQR 70–79).

PGC was performed in 54 (49.1%) patients with low-risk PCa, 42 (38.1%) with intermediate risk and 14 (12.8%) high risk.

At a median follow-up of 36 months, we recorded a BCS and TFS of 75 and 81%, respectively.

At 5 years, BCS was 68.5% and CRS 71.5%.

High-risk prostate cancer was associated with lower TFS and BCS curves when compared with low-risk group (all p  values < .03).

A PSA reduction < 50% between preoperative level and nadir resulted as an independent failure predictor for all outcomes evaluated (all p  values < .01).

Age was not associated with worse outcomes.

Conclusions PGC could be a valid treatment for low- to intermediate PCa in elderly patients, when a curative approach is suitable in terms of life expectancy and quality of life.