Salvage Ablation for Locally Recurrent Prostate Cancer

Derek J. Lomas; David A. Woodrum; Lance A. Mynderse

Curr Opin Urol. 2021;31(3):188-193.

Ablation for Treatment of Radiorecurrent Prostate Cancer

In patients who are appropriate candidates for salvage local therapy, but are unfit or adverse to salvage prostatectomy, salvage ablation offers a minimally invasive option. Currently, cryotherapy and HIFU are salvage ablation modalities based on guidelines and will be the focus of this update.^[1,2]

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Abstract and Introduction
Patient Identification and Selection
Ablation for Treatment of Radiorecurrent Prostate Cancer
Salvage Cryotherapy
Oncologic Outcomes
Adverse Effects
Salvage High-intensity Focused Ultrasound
Oncologic Outcomes
Adverse Effects
Postprostatectomy Salvage Ablation
Conclusion
References
Sidebar

Table 1. Salvage cryotherapy outcomes
Author	n	Ablation type	Median follow-up (months)	Biochemical recurrence-free survival	Androgen deprivation therapy initiation	Metastasis	Overall survival	Prostate cancer specific mortality
Bain et al. [10]	37	Whole gland	56.1	71%, 2 years	–	19%, 4.7 years	–	–
Bomers et al. [11]	62	Focal ablation	12	62.6%, 1 year	–	16.1%, 1 year	–	–
Exterkate et al. [12]	169	Whole gland	36	52%, 5 years	30%, 5 years	43%, 5 years	77%, 10 years	–
Nair et al. [13]	187	Whole gland	149	44.2%, 10 years	51%, 10 years	21.2%, 10 years	–	15.8%, 10 years
Safavy et al. [14]	75	Whole gland (93.3%) Hemiablation (6.7%)	46.8	50.7%, 3.9 years	30.7%, 3.9 years	13.3%, 3.9 years	92% at last follow-up	–
Bauman et al. [18]	169	Whole gland	216	–	90%, 20 years	–	–	16.2%, 10 years

Table 2. Salvage high-intensity focused ultrasound outcomes
Author	n	Ablation type	Median follow-up	Biochemical recurrence-free survival	Androgen deprivation therapy initiation	Metastasis	Overall survival	Prostate cancer specific mortality
Nair et al. [13]	113	Whole gland	77	28.7%, 10 years	52.5%, 10 years	23.8 (10 years)	–	15.2%, 10 years
Devos et al. [21]	27	Whole gland	45	51%, 5 years	–	39.7%, 5 years	80.9%, 5 years	16%, 5 years
Hostiou et al. [22]	50	Whole gland (70%) Hemiablation (30%)	55	41%, 6 years	42%, 4.6 years	18%	93%, 6 years	8%, 7 years