Objective: To present the early results of the use of third-generation cryotherapy in primary and recurrent prostate cancer at one UK centre.
Patients and methods: Over a 14-month period 51 patients underwent cryotherapy for prostate cancer. In 31 patients cryotherapy was used as the primary treatment and in 20 as a salvage treatment after radiotherapy or hormone ablation. Data were collected prospectively and the median follow-up was 9 months.
Results: The prostate-specific antigen (PSA) level decreased to <0.5 ng/mL in 79% of patients undergoing primary treatment and in 67% of patients undergoing salvage treatment. A higher Gleason grade and PSA levels were associated with a poorer outcome. No patient developed a fistula, 4% developed urinary retention requiring transurethral prostatectomy and 4% had persistent incontinence. The rates of erectile dysfunction were high (86%). The median inpatient stay was 2 days.
Conclusion: Early results suggest that cryotherapy offers a safe alternative for primary and recurrent prostate cancer, particularly for older and less fit patients. Long-term data are required to assess the durability of response and the effect on survival.