Whole and hemi-gland cryoablation for primary localized prostate cancer: Short and medium-term oncological and functional outcomes

Introduction: To compare oncological, functional and post-operative outcomes of hemi (HC) vs. whole gland (WGC) cryoablation as first line treatment of localized prostate cancer. Material and method: Sixty-six consecutive patients undertaking whole-gland cryoablation (WGC = 40) or hemi-cryoablation (HC = 26) in a tertiary referral centre between 2010 and 2018 were included. All patients had a low-intermediate risk prostate cancer according to D'Amico risk classification. Hemi-ablation was proposed in case of biopsy and prostate MRI proven unilateral prostate cancer. Primary endpoint was Cryotherapy Failure for which 3 definitions were considered and compared: 1) biochemical failure (> PSA nadir + >= 2 ng/mL), 2) positive prostate re-biopsy with Gleason score >= 7, 3) initiation of further prostate cancer treatment. Results: Median patients age at treatment was 74 [42-81] vs. 76 [71-80] years in WGC vs. HC group, respectively (p = .08). Low and intermediate D'Amico risk group were 15% and 85% vs. 23% and 77% (p = .75), respectively. Median follow- up time was 41 [1.5-99.0] vs. 27 [0.9-93] months (p = .03). Four-years cryotherapy failure free survival in WGC vs. HC were 69% vs. 53% with definition 1 (p = .24), 82% vs. 80% with definition 2 (p = .95), 83% vs. 77% with definition 3 (p = .73). Early and 1-year urinary continence were 60% and 83% in WGC vs. 72% and 83% in HC (p = .26). De novo impotency after cryotherapy was 75% vs. 46% (p = .33) in WGC vs. HC. Conclusions: In our cohort of highly selected patients with unilateral low/intermediate risk PCa, hemi-cryoablation may provide similar oncological outcomes and less early complications compared to whole-gland cryoablation. (C) 2019 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.