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MP-16.22 Prostate Cancer Location Concordance Analysis Between Prostate Biopsies and Radical Prostatectomy Specimens
MODERATED POSTER SESSIONS
1
Dept. of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, USA; 2 Dept. of Urology, Urology of Virginia, Norfolk, USA; 3Dept. of Regional Urology, Cleveland Clinic, Cleveland, USA Introduction and Objectives: In the present study, we evaluate the contemporary outcomes of salvage cryotherapy for locally recurrent prostate cancer using the COLD (Cryo On-Line Data) Registry. Furthermore, we evaluate the outcomes of salvage cryotherapy in achieving the therapeutic “bifecta” consisting of: (1) achieving a post-cryotherapy nadir serum PSA ⬍ 0.6 ng/ml and (2) no urinary incontinence. Materials and Methods: A prospectively, centrally collected secure online database has been developed of patients undergoing salvage cryoablation for locally recurrent prostate cancer. Of the patients undergoing salvage cryotherapy (in the absence of neoadjuvant hormonal ablative therapy) included within the COLD Registry, complete medical records pertaining to continence status and serial PSA measurements post-treatment were available in 183 patients.
Results: The therapeutic “bifecta” was achieved in 133 of these patients (72.7%). Of the patients achieving the “bifecta”, mean age at presentation was 71.5 years (⫹/⫺ 6.6 years). The majority of patients (91%) had a baseline total serum PSA ⬍
10 ng/m and a pre-treatment biopsy Gleason score ⬍ 8 (85%). Conclusions: The therapeutic “bifecta” a new surrogate benchmark for salvage therapies can be achieved in the majority of patients undergoing salvage cryotherapy. Therefore, salvage cryotherapy is a reasonable treatment choice for locally recurrent prostate cancer in appropriately selected patients.
MP-16.22 Prostate Cancer Location Concordance Analysis Between Prostate Biopsies and Radical Prostatectomy Specimens Kim S, Kim S, Sung G, Park C, Kim H, Park J Dept. of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea Introduction and Objective: For localized prostate cancer (PC), determining the location of the cancer is a key element in the process of deciding on the optimal operative treatment method. The authors examined cancer location concordance between prostate biopsies and radical prostatectomy specimens (RPS), and investigated factors that influence concordance rate. Materials and Methods: The participants were 154 patients who received prostate biopsies, were diagnosed with PC and underwent radical prostatectomy during the period from 1997 to 2010. All patients received 12-core prostate biopsies. Results: Observations matched in 93.8% of patients in whom the cancer had developed bilaterally, but only 31.1% of obser-
UROLOGY 78 (Supplement 3A), September 2011
S155
MODERATED POSTER SESSIONS
vations matched when the cancer was observed unilaterally in the biopsy. When patients were classified as either those whose prostate biopsy results match the RPS in terms of cancer location (“matching” group) or those whose results do not match (“non-matching” group), the Gleason score from the biopsy and the RPS, number of cores in which PC was detected in the biopsy, cancer volume detected in the RPS and percent cancer in the prostate were noticeably higher for the matching group Conclusions: If a patient has a total Gleason score of 7 or less, has 2 or fewer detected cores and the PC has developed unilaterally, the actual RPS is likely to indicate a different cancer location. This must be noted carefully when deciding on the operative treatment method, and there is a need to develop image modality to determine the exact location of cancers.
S156
UROLOGY 78 (Supplement 3A), September 2011
1
Dept. of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, USA; 2 Dept. of Urology, Urology of Virginia, Norfolk, USA; 3Dept. of Regional Urology, Cleveland Clinic, Cleveland, USA Introduction and Objectives: In the present study, we evaluate the contemporary outcomes of salvage cryotherapy for locally recurrent prostate cancer using the COLD (Cryo On-Line Data) Registry. Furthermore, we evaluate the outcomes of salvage cryotherapy in achieving the therapeutic “bifecta” consisting of: (1) achieving a post-cryotherapy nadir serum PSA ⬍ 0.6 ng/ml and (2) no urinary incontinence. Materials and Methods: A prospectively, centrally collected secure online database has been developed of patients undergoing salvage cryoablation for locally recurrent prostate cancer. Of the patients undergoing salvage cryotherapy (in the absence of neoadjuvant hormonal ablative therapy) included within the COLD Registry, complete medical records pertaining to continence status and serial PSA measurements post-treatment were available in 183 patients.
Results: The therapeutic “bifecta” was achieved in 133 of these patients (72.7%). Of the patients achieving the “bifecta”, mean age at presentation was 71.5 years (⫹/⫺ 6.6 years). The majority of patients (91%) had a baseline total serum PSA ⬍
10 ng/m and a pre-treatment biopsy Gleason score ⬍ 8 (85%). Conclusions: The therapeutic “bifecta” a new surrogate benchmark for salvage therapies can be achieved in the majority of patients undergoing salvage cryotherapy. Therefore, salvage cryotherapy is a reasonable treatment choice for locally recurrent prostate cancer in appropriately selected patients.
MP-16.22 Prostate Cancer Location Concordance Analysis Between Prostate Biopsies and Radical Prostatectomy Specimens Kim S, Kim S, Sung G, Park C, Kim H, Park J Dept. of Urology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea Introduction and Objective: For localized prostate cancer (PC), determining the location of the cancer is a key element in the process of deciding on the optimal operative treatment method. The authors examined cancer location concordance between prostate biopsies and radical prostatectomy specimens (RPS), and investigated factors that influence concordance rate. Materials and Methods: The participants were 154 patients who received prostate biopsies, were diagnosed with PC and underwent radical prostatectomy during the period from 1997 to 2010. All patients received 12-core prostate biopsies. Results: Observations matched in 93.8% of patients in whom the cancer had developed bilaterally, but only 31.1% of obser-
UROLOGY 78 (Supplement 3A), September 2011
S155
MODERATED POSTER SESSIONS
vations matched when the cancer was observed unilaterally in the biopsy. When patients were classified as either those whose prostate biopsy results match the RPS in terms of cancer location (“matching” group) or those whose results do not match (“non-matching” group), the Gleason score from the biopsy and the RPS, number of cores in which PC was detected in the biopsy, cancer volume detected in the RPS and percent cancer in the prostate were noticeably higher for the matching group Conclusions: If a patient has a total Gleason score of 7 or less, has 2 or fewer detected cores and the PC has developed unilaterally, the actual RPS is likely to indicate a different cancer location. This must be noted carefully when deciding on the operative treatment method, and there is a need to develop image modality to determine the exact location of cancers.
S156
UROLOGY 78 (Supplement 3A), September 2011