Focal ablative salvage therapy for radio-recurrent prostate cancer: 6 year oncological and safety outcomes
BAUS ePoster online library. Reddy D. 06/21/21; 319059; p2-10
Disclosure(s): Deepika Reddy's research was funded by Prostate Cancer UK and has received grants from Sonacare and Imperial College Healthcare Charity to travel to conferences.
Deepika Reddy
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Abstract
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Introduction:
Radiotherapy is effective in the treatment of non-metastatic prostate cancer. When recurrence occurs, patients are usually managed with watchful waiting and systemic therapy due to significant urinary and rectal morbidity resulting from salvage prostatectomy. Focal ablative salvage therapy (FAST) may provide oncological control with fewer adverse effects. We report on outcomes following FAST using high intensity focused ultrasound (HIFU) or cryotherapy.
Patients and Methods:
Within the UK's HEAT and ICE prospective registries, 288 consecutive patients across 8 sites underwent FAST for recurrence after radiotherapy (11/2006-7/2020). 221 (76.5%) underwent HIFU and 67 (23.2%) underwent cryotherapy (for mostly anterior or T3b disease). Follow-up data was available in 265 cases. Primary outcome was failure-free survival (FFS) defined as avoidance of systemic therapy, whole-gland treatment, metastases or prostate cancer-specific death. Secondary outcomes were overall survival and adverse events.
Results:
Median (IQR) age was 70 years (66-74) and PSA 5.3ng/ml (3.3-8.2). 188/288 (65.3%) had rT2 and 68 (23.6%) rT3 disease, 105 (36.5%), 89 (30/9%) and 62 (21.5%) had ISUP Grade Group 2, 3 and >3 respectively. Overall median (IQR) follow-up was 23.3 months (12.6-44.9). FFS (95%CI) at 3 and 6 years was 90% (86-95%) and 77% (66-90%), respectively (Figure1). Overall survival (95%CI) at 3 and 6 years was 97% (94-100%) and 82% (73-94%), respectively. Adverse events were reported in 7.3% (21/288) patients, with 3 developing a recto-urethral fistula.
Conclusions:
Focal ablative salvage therapy for radio-recurrent prostate cancer has low rates of significant adverse events and provides good short to medium-term oncological control.
Radiotherapy is effective in the treatment of non-metastatic prostate cancer. When recurrence occurs, patients are usually managed with watchful waiting and systemic therapy due to significant urinary and rectal morbidity resulting from salvage prostatectomy. Focal ablative salvage therapy (FAST) may provide oncological control with fewer adverse effects. We report on outcomes following FAST using high intensity focused ultrasound (HIFU) or cryotherapy.
Patients and Methods:
Within the UK's HEAT and ICE prospective registries, 288 consecutive patients across 8 sites underwent FAST for recurrence after radiotherapy (11/2006-7/2020). 221 (76.5%) underwent HIFU and 67 (23.2%) underwent cryotherapy (for mostly anterior or T3b disease). Follow-up data was available in 265 cases. Primary outcome was failure-free survival (FFS) defined as avoidance of systemic therapy, whole-gland treatment, metastases or prostate cancer-specific death. Secondary outcomes were overall survival and adverse events.
Results:
Median (IQR) age was 70 years (66-74) and PSA 5.3ng/ml (3.3-8.2). 188/288 (65.3%) had rT2 and 68 (23.6%) rT3 disease, 105 (36.5%), 89 (30/9%) and 62 (21.5%) had ISUP Grade Group 2, 3 and >3 respectively. Overall median (IQR) follow-up was 23.3 months (12.6-44.9). FFS (95%CI) at 3 and 6 years was 90% (86-95%) and 77% (66-90%), respectively (Figure1). Overall survival (95%CI) at 3 and 6 years was 97% (94-100%) and 82% (73-94%), respectively. Adverse events were reported in 7.3% (21/288) patients, with 3 developing a recto-urethral fistula.
Conclusions:
Focal ablative salvage therapy for radio-recurrent prostate cancer has low rates of significant adverse events and provides good short to medium-term oncological control.
Introduction:
Radiotherapy is effective in the treatment of non-metastatic prostate cancer. When recurrence occurs, patients are usually managed with watchful waiting and systemic therapy due to significant urinary and rectal morbidity resulting from salvage prostatectomy. Focal ablative salvage therapy (FAST) may provide oncological control with fewer adverse effects. We report on outcomes following FAST using high intensity focused ultrasound (HIFU) or cryotherapy.
Patients and Methods:
Within the UK's HEAT and ICE prospective registries, 288 consecutive patients across 8 sites underwent FAST for recurrence after radiotherapy (11/2006-7/2020). 221 (76.5%) underwent HIFU and 67 (23.2%) underwent cryotherapy (for mostly anterior or T3b disease). Follow-up data was available in 265 cases. Primary outcome was failure-free survival (FFS) defined as avoidance of systemic therapy, whole-gland treatment, metastases or prostate cancer-specific death. Secondary outcomes were overall survival and adverse events.
Results:
Median (IQR) age was 70 years (66-74) and PSA 5.3ng/ml (3.3-8.2). 188/288 (65.3%) had rT2 and 68 (23.6%) rT3 disease, 105 (36.5%), 89 (30/9%) and 62 (21.5%) had ISUP Grade Group 2, 3 and >3 respectively. Overall median (IQR) follow-up was 23.3 months (12.6-44.9). FFS (95%CI) at 3 and 6 years was 90% (86-95%) and 77% (66-90%), respectively (Figure1). Overall survival (95%CI) at 3 and 6 years was 97% (94-100%) and 82% (73-94%), respectively. Adverse events were reported in 7.3% (21/288) patients, with 3 developing a recto-urethral fistula.
Conclusions:
Focal ablative salvage therapy for radio-recurrent prostate cancer has low rates of significant adverse events and provides good short to medium-term oncological control.
Radiotherapy is effective in the treatment of non-metastatic prostate cancer. When recurrence occurs, patients are usually managed with watchful waiting and systemic therapy due to significant urinary and rectal morbidity resulting from salvage prostatectomy. Focal ablative salvage therapy (FAST) may provide oncological control with fewer adverse effects. We report on outcomes following FAST using high intensity focused ultrasound (HIFU) or cryotherapy.
Patients and Methods:
Within the UK's HEAT and ICE prospective registries, 288 consecutive patients across 8 sites underwent FAST for recurrence after radiotherapy (11/2006-7/2020). 221 (76.5%) underwent HIFU and 67 (23.2%) underwent cryotherapy (for mostly anterior or T3b disease). Follow-up data was available in 265 cases. Primary outcome was failure-free survival (FFS) defined as avoidance of systemic therapy, whole-gland treatment, metastases or prostate cancer-specific death. Secondary outcomes were overall survival and adverse events.
Results:
Median (IQR) age was 70 years (66-74) and PSA 5.3ng/ml (3.3-8.2). 188/288 (65.3%) had rT2 and 68 (23.6%) rT3 disease, 105 (36.5%), 89 (30/9%) and 62 (21.5%) had ISUP Grade Group 2, 3 and >3 respectively. Overall median (IQR) follow-up was 23.3 months (12.6-44.9). FFS (95%CI) at 3 and 6 years was 90% (86-95%) and 77% (66-90%), respectively (Figure1). Overall survival (95%CI) at 3 and 6 years was 97% (94-100%) and 82% (73-94%), respectively. Adverse events were reported in 7.3% (21/288) patients, with 3 developing a recto-urethral fistula.
Conclusions:
Focal ablative salvage therapy for radio-recurrent prostate cancer has low rates of significant adverse events and provides good short to medium-term oncological control.
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