Salvage cryoablation for local recurrence of prostatic cancer after curative therapy

Abstract Purpose The purpose of this study was to determine the efficacy of salvage cryotherapy for intra-prostatic and local extraprostatic recurrences after curative treatment of prostate adenocarcinoma. Material and method Twenty-eight men (mean age, 69 ± 6 [SD] years; range: 51–82 years) treated with cryoablation for prostatic ( N  = 21) or extraprostatic ( N  = 7) recurrent prostate cancer after radiotherapy with or without associated prostatectomy were included. Technical success, complication and recurrences were reported. Biological recurrence was defined as an elevation ≥ 2 ng/mL of prostate specific antigen (PSA) serum level after the treatment. Results The mean follow-up was 18 months. Among the 21 patients with intraprostatic recurrence, 14 had successful cryotherapy with a mean decrease in serum prostate-specific antigen (PSA) levels of − 5.7 ± 2.6 (SD) ng/mL (range: − 2.1 to − 16.9 ng/mL). Four patients (19%) had early progression and three patients (14%) had delayed biological recurrence (mean time: 15 months). Among the 7 patients with extraprostatic recurrence, 2/7 (291%) had successful cryotherapy with a decrease in PSA serum level of − 2.7 ± 1.6 (SD) ng/mL (range: − 0.5–− 5.5 ng/mL) and 4/7 (57%) had early biological recurrence after cryotherapy that required androgen deprivation therapy, whereas 1/7 (4%) was lost to follow-up. No major complications were observed for both intra- and extraprostatic recurrence. Conclusion Salvage cryoablation of locally recurrent prostate cancer after curative treatment is feasible and safe when the half prostate is treated. It could delay initiation of androgen deprivation therapy in these patients.