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Five-Year Biochemical Progression-Free Survival Following Salvage Whole-Gland Prostate Cryoablation: Defining Success with Nadir Prostate-Specific Antigen.

Publication ,  Journal Article
Kovac, E; ElShafei, A; Tay, KJ; Mendez, M; Polascik, TJ; Jones, JS
Published in: J Endourol
June 2016

BACKGROUND AND OBJECTIVES: Salvage prostate cryoablation is an effective treatment for patients with localized prostate cancer relapse following primary radiotherapy. The postsalvage prostate-specific antigen (PSA) nadir that best predicts long-term biochemical progression-free survival (bPFS) is not yet defined. We sought to determine what nadir PSA best predicted success following salvage whole-gland cryoablation. PATIENTS AND METHODS: We retrospectively reviewed a cohort of 486 hormone-naive patients who underwent salvage whole-gland cryoablation from the Cryo On-Line Database (COLD). Studied variables were age, race, initial PSA, presalvage prostate-specific antigen (psPSA), initial Gleason score, Gleason score at presalvage biopsy, clinical stage, and follow-up PSA values. Kaplan-Meier (KM) analysis was used to calculate 5-year bPFS using the Phoenix criteria. Hazard ratio and relative risk were also analyzed. Differences among the KM estimates, at 5 years, were calculated using the log-rank test. RESULTS: Using group thresholds, KM analysis identified nadir PSA less than or greater than 0.4 ng/mL as the nadir PSA threshold, with the greatest difference in bPFS. The KM estimated 5-year bPFS was 75.5% and 22.1% for nadir PSA <0.4 and ≥0.4 ng/mL, respectively. Stratified by psPSA, the KM estimated 5-year bPFS comparing patients with PSA nadir <0.4 vs ≥0.4 ng/mL was 78.5% and 17.9% (p < 0.0001) for psPSA <4 ng/mL, 77.1% and 15.7% (p < 0.0001) for psPSA 4-10 ng/mL, and 77.8% and 16.8% (p < 0.0001) for psPSA >10 ng/mL, respectively. CONCLUSION: The best objective indicator of biochemical success following whole-gland salvage cryoablation of the prostate is PSA nadir <0.4 ng/mL.

Duke Scholars

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

June 2016

Volume

30

Issue

6

Start / End Page

624 / 631

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Time Factors
  • Salvage Therapy
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
  • Middle Aged
 

Citation

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Kovac, E., ElShafei, A., Tay, K. J., Mendez, M., Polascik, T. J., & Jones, J. S. (2016). Five-Year Biochemical Progression-Free Survival Following Salvage Whole-Gland Prostate Cryoablation: Defining Success with Nadir Prostate-Specific Antigen. J Endourol, 30(6), 624–631. https://doi.org/10.1089/end.2015.0719
Kovac, Evan, Ahmed ElShafei, Kae Jack Tay, Melissa Mendez, Thomas J. Polascik, and J Stephen Jones. “Five-Year Biochemical Progression-Free Survival Following Salvage Whole-Gland Prostate Cryoablation: Defining Success with Nadir Prostate-Specific Antigen.J Endourol 30, no. 6 (June 2016): 624–31. https://doi.org/10.1089/end.2015.0719.
Kovac, Evan, et al. “Five-Year Biochemical Progression-Free Survival Following Salvage Whole-Gland Prostate Cryoablation: Defining Success with Nadir Prostate-Specific Antigen.J Endourol, vol. 30, no. 6, June 2016, pp. 624–31. Pubmed, doi:10.1089/end.2015.0719.
Journal cover image

Published In

J Endourol

DOI

EISSN

1557-900X

Publication Date

June 2016

Volume

30

Issue

6

Start / End Page

624 / 631

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Treatment Outcome
  • Time Factors
  • Salvage Therapy
  • Retrospective Studies
  • Prostatic Neoplasms
  • Prostate-Specific Antigen
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
  • Middle Aged