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67th Annual Meeting Abstracts
Focal/Partial Gland Prostate Cryoablation: Results of 795 Patients from Multiple Centers Tracked with the COLD Registry
Robert W Given1, *Stephen Jones2
1Eastern Virginia Medical School, Norfolk, VA;2Cleveland Clinic, Cleveland, OH
Introduction: Cryotherapy for prostate cancer traditionally targets treatment of the whole gland. While efficacious, this ablates healthy tissue thereby increasing morbidity. Focal prostate cryo addresses only known cancerous foci. We report the outcomes of focal cryo at a number of centers participating in the Cryo On-Line Database (COLD). These early data on 795 men comprise the first multicenter report.
Methods: 795 focal cryo patients were stratified by D’Amico risk classifications. Biochemical failure was determined by the ASTRO definition. Biopsy was performed at the physician’s discretion. Incontinence was the use of any pads. Intercourse was the ability to penetrate and complete with or without assistance.
Results: Median age of patients was 68 (37-85). Median followup is 1 year. Actuarial disease free survivals are reported in the figure. Positive biopsies were reported in 36 patients (4.5% of the cohort, 25% of patients undergoing biopsy). 3 (0.4%) rectal fistulas were reported between 6 weeks and 12 months postop. Incontinence was reported in 11 pts (2.8%). Of the 134 patients potent prior to cryo, 87 (65%) were sexually active 12 months postop.
Conclusions: Focal prostate cryo is controversial. It is associated with low morbidity - most notably, a majority of men resume intercourse. Early efficacy is supported by encouraging 60 month BDFS rates in men with low and intermediate risk, but men with high risk disease have less favorable outcomes. 
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