Short Communication
Published: 2018-12-15

Radical prostate cancer treatment in the elderly: role of cryotherapy

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Department of Urology, Kirurski Sanatorij Ljubljana, Slovenia
Department of Urology, Henri Mondor Hospital, Créteil, France
Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy
Elderly Cryotherapy Prostate cancer Prostate biopsy

Abstract

Background & Aims. Data regarding efficacy and safety of radical cryotherapy for localized prostate cancer
in elderly men are lacking. This study aimed to determine oncological and functional outcomes of radical cryotherapy
in this setting.
Methods. From our dedicated Internal Review Board approved prospectively maintained database we selected
elderly (> 75 years) patients with localized prostate cancer as assessed by a negative staging choline-
PET. After cryotherapy, patients were seen at 1 month, every 3 months for the first two years, then every
six months, for clinical examination, serum PSA, questionnaires for lower urinary tract symptoms (IPSS)
and erectile function (IIEF-5), and assessment of pad usage for urinary continence. Biochemical recurrence
was defined as a rising PSA above the Nadir of more than 2 ng/mL. Complications were scored using the
Clavien-Dindo scale.
Results. From March 2012 to June 2018, 45 patients met the inclusion criteria. Mean postoperative hospital
stay was for 1.06 days. At median follow-up (41 months), biochemical failure occurred in 8.8% of patients,
with Kaplan-Meier plots showing an estimated 85% biochemical-free survival at 5y. Three (6.6%) patients
reported urge urinary incontinence needing at least 2 pad/day; they were treated by antimuscarinic agents
with complete symptoms resolution in 2 and relevant benefit in one. No patient suffered stress urinary incontinence.
Conclusions. This is the first study testing radical cryoablation in the setting of elderly patient. It showed excellent
5y biochemical recurrence-free survival not only in intermediate-risk but also in high-risk patients at the
price of a reasonable/low rate of minor complications.

Affiliations

G. Silecchia

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

O. Selvaggio

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

G. Stallone

Nephrology, Dialysis and Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

F. Lugnani

Department of Urology, Kirurski Sanatorij Ljubljana, Slovenia

A. Hoznek

Department of Urology, Henri Mondor Hospital, Créteil, France

G. Carrieri

Urology and Renal Transplantation Unit, Department of Medical and Surgical Sciences, University of Foggia, Italy

Copyright

© Società Italiana di Gerontologia e Geriatria (SIGG) , 2018

How to Cite

[1]
Silecchia, G., Selvaggio, O., Stallone, G., Lugnani, F., Hoznek, A. and Carrieri, G. 2018. Radical prostate cancer treatment in the elderly: role of cryotherapy. JOURNAL OF GERONTOLOGY AND GERIATRICS. 66, 4 (Dec. 2018), 189-194.
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