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Primary Prostate Cryoablation: COLD Registry Outcomes
John P Foley1, Louis L Pisters*2, Bryan J Donnelly*3, Franco M Lugnani*4, Aaron E Katz*5, John C Rewcastle*3, J Stephen Jones*6
1Eastern Short Urology Associates, Easton, MD;2MD Anderson Cancer Clinic, Houston, TX;3University of Calgary, Calgary, AB, Canada4Society for Cryosurgery, Trieste, Italy5Columbia University, New York, NY;6Cleveland Clinic, Cleveland, OH
Introduction: The use of cryoablation has increased in recent years. We report the outcomes of modern cryoablation at a large number of centers, both academic and community, which have participated in the Cryo On-Line Data (COLD) Registry.
Methods: Data from 1608 primary cryoablation patients was housed in a secure online database. This analysis includes only 690 who had at least 24 months of follow-up. Patients were stratified according to D’Amico’s 2003 risk groups. Biochemical failure was defined according to both ASTRO (3-rises and nadir+2) definitions. Biopsy was performed at the physician’s discretion, but most commonly if a patient had a rising or suspicious PSA.
Results: The average age was 67.8±7.8 years, PSA: 9.7±10.2 ng/ml, and Gleason: 6.5±1.3. Patients were followed for 48.3±26.2 months. Five year biochemical survival (3-rises) was, 72.4±2.0, 78.4±5.3, 72.5±3.6 and 67.1±3.3 for all, low, moderate and high risk, respectfully. Five year biochemical survival (nadir+2) was, 78.9±1.8, 93.3±2.5, 84.6±3.1 and 68.2±3.4 for all, low, moderate and high risk, respectfully. A total of 304 underwent post treatment biopsy. Of these, 53 showed evidence of disease resulting in a positive biopsy rate for those who underwent biopsy of 17.4%. The positive biopsy rate of the entire population was 53/690 (4.9%).
Conclusions: Cryoablation, as a primary treatment for prostate cancer practiced over a wide spectrum of users provides durable biochemical and local control through five years.
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