MP78-09 5-YEARS BIOCHEMICAL RECURRENCE AND OVERALL SURVIVAL RATES AFTER RADICAL PROSTATECTOMY OR HIGH DOSE RADIATION BRACHYTHERAPY WITH ADDITIONAL EXTERNAL BEAM IN PATIENTS WITH CLINICALLY LOCALIZED PROSTATE CANCER

INTRODUCTION AND OBJECTIVES: Locally radio-recurrent prostate cancer (rr-PCa) can offer a chance of cure albeit with potential morbidities. Current salvage treatment options include radical surgery and minimally-invasive ablative modalities such as HIFU and cryosurgery (s-cryo). Current data suggests that s-cryo can achieve diseasefree survival (DFS) rates up to 60% at 5yr. However, the majority of data is based on retrospective analysis with mid-term follow-up and there is still paucity of data on long-term outcomes. The aim of this study was to analyze morbidity and oncological outcomes, with median follow-up 10 years, of s-cryo on rr-PCa patients at an academic center METHODS: A retrospective analysis was performed on 187 patients who underwent s-cryo at our center for biopsy-proven rr-PCa from 1995 to 2004. Two freeze-thaw cycles of transperineal cryo were performed under TRUS guidance by a single surgeon. Patients’ preoperative, perioperative, and postoperative features were reviewed from a prospectively maintained database. Complications were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) system v2.0. Recurrence was defined using the Phoenix definition (nadir þ 2ng/ml) as well as any radiologic, histologic, or clinical evidence of recurrent PCa. DFS was defined as the time period from scryo to date of recurrence. Primary outcome was survival. Secondary outcomes included morbidity and DFS. Statistical analysis was carried out using Kaplan-Meier method for survival and t-student and c2 tests for continuous and grouped data, respectively (SPSSv.17, p 10 and >15 yr respectively. Overall, 39 patients (20.9%) died during follow-up either due to PCa (9) or other causes (30). DFS at 10 yr was 39%. Four patients (2.1%) developed recto-urethral fistula (successfully repaired), and 13 patients (7%) had bladder neck contracture requiring urethrotomy. Acute urinary retention requiring Foley catheter was observed in 40 cases (21.4%) and severe gross hematuria requiring bladder washout was recorded in 21 (11.2%). CONCLUSIONS: S-cryo is a viable minimally invasive treatment option for rr-PCa. Reasonable long-term DFS with acceptable morbidity can be achieved in a significant portion of patients with rr-PCa.