MP30-19: Propensity Score Comparative Matching of Oncological and Functional Outcomes of Primary Focal vs Who

Propensity Score Comparative Matching of Oncological and Functional Outcomes of Primary Focal vs Whole Gland Cryotherapy for Prognostic Grade Groups (PGG) 4 and 5 Prostate Cancer

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INTRODUCTION

To compare the oncologic and functional outcomes of partial vs whole-gland cryotherapy for men with high grade PGG 4-5 prostate cancer.

METHODS

A 1:5 matched comparison of men with PGG 4-5 (Gleason score 8-10) prostate cancer treated with partial gland (targeted ablation, unilateral/bilateral nerve-sparing ablations) or whole gland prostate cryotherapy in the primary setting were included. A propensity score was developed based on age, prebiopsy serum prostate-specific antigen, biopsy Gleason score and clinical stage. Outcomes include oncological control defined by biochemical progression-free survival (BPFS) using Phoenix criteria, and positive post-cryo biopsy rates. Functional outcomes assessed were urinary retention, 12-month urinary continence (defined as strictly pad-free), and sexual function (patient reported, with/without intervention, potency sufficient for sexual intercourse).

RESULTS

Overall 546 men were identified. Post matching, 312 men were analyzed (52 partial gland and 260 whole gland) with mean follow-up 40± 37.4 months. There were no statistically significant differences between the 2 matched groups regarding median age (70 vs. 72, p=0.2), median pretreatment PSA (6.2 vs. 6.3 p= 0.3), Gleason score > 8 (19.2% vs. 21.9% P=0.67), neoadjvant therapy (41.2% vs.45.6%, P=0.57), clinical stage ≥ T2b (32.4% vs. 44.5%, p=0.17) and median prostate volume (32 vs. 32.3cc, p=0.67) for partial and whole gland primary cryoablation, respectively. The 2/5-year BPFS rate was 88.5% / 69.2% for partial-gland vs 72.6 /52.7% for whole gland ablation (p = 0.10, Figure1). The 12-month continence rate was 100% vs 96.4% (p = 0.17), the 12-month rate of effective intercourse was 73.3% vs. 29.3% (p