Barqawi A, et al. - Researchers aimed at assessing the rate of complications and change in IPSS and SHIM scores following cryotherapy treatment of low and intermediate risk prostate cancer. Secondarily, they assessed change in PSA post-cryotherapy and biopsy-proven recurrence. Compared to previous reports, this study indicated decreased complication rates, most significantly erectile dysfunction for cryotherapy for prostate cancer.

Methods

• From 2007-2015, researchers performed enrollment to assess long-term complications of cryotherapy.
• At one year or in the event of biochemical failure, they performed a prostate biopsy.
• They staged and graded subjects by standard 12-14 core TRUS biopsy.
• If the cancer was suspected to be downgraded, a subset of subjects underwent additional 3DMB.
• They stratified the analyses of functional outcomes into focal and non-focal treatment.

Results

• This study enrolled 393 men with low and intermediate risk prostate cancer, aged 44-89 years.
• Researchers observed significant improvement in patient IPSS scores in the non-focal treatment strata at all time points, and after 1 year in the focal strata with a median drop at 1 year of 4 points (p<0.001).
• They identified no marked difference for a change in pre-procedural SHIM score in either treatment strata after two years (p>0.7).
• Rise in PSA resulting in biochemical failure was observed in 82 patients (20.9%).
• They observed recurrence in 70 patients; an overall recurrence rate was 20.4%.
• Urinary retention and urgency were reported by 109 patients (27.7%) post-cryotherapy, with 15.3% requiring catheterization for up to 3 weeks.
• In this study, 37 patients (9.4%) experienced urethral meatal stricture, and 36 patients (9.2%) reported unresolved new-onset ED.