Currently, there are a number of different treatments used to treat recurrent prostate cancer when the primary treatment had radiation has failed. In this situation surgery is considered very difficult and can only be successfully performed by an experienced surgeon, so alternative treatments are often considered. Long-term data about the success of these alternative treatments has not yet matured, however we do have some insight into the immediate morbidities caused by some of them.
A group of researchers compared the morbidity of whole gland salvage ablation using cryotherapy (CRYO) as well as high-intensity focused ultrasound (HIFU) for radio recurrent prostate cancer at a single center over a 17-year period.
The researchers divided their subjects into 3 cohorts. The cohorts included men who had been treated with CRYO (1995-1998); men treated with CRYO (2002-2004), and another cohort treated with HIFU (2006-2011). They then analyzed the side effects as reported within at least 90 days of treatment or up to the men’s last follow-up appointment.
They found that the rate of mild to moderate incontinence was significantly higher in the CRYO group compared to the HIFU cohort (p ? 0. 05). The rate of urinary retention was significantly higher in Group 2 compared to Group 3 (p = 0. 0005). The rates of severe incontinence (range: 1. 5%-5%) eventually requiring surgical intervention (uniform at 1. 5%), and recto-urethral fistulae (range: 1. 5%-3%) were not statistically different.
The researchers have concluded that CRYO was associated with higher overall morbidity (side effects). The morbidity during the early experience with HIFU was lower than both subgroups of CRYO. This may reflect the advancement of technology or cumulative learning experience of the practitioners.
Canadian Urological Association journal = Journal de l’Association des urologues du Canada. 0000 [Epub]
Khurram M Siddiqui, Michele Billia, Andrew Williams, Ali Alzahrani, Joseph L Chin