Ultrasound-Guided Focal Cryoablation for Localized Prostate Cancer: 7-Year Oncological and Functional Outcomes

This study aimed to evaluate the long-term oncological and functional outcomes of focal cryoablation for treating non-metastatic prostate cancer (PCa). Traditional radical treatments, though effective, often come with complications and functional declines, making them unsuitable for some patients. Focal ablation offers a promising alternative by providing good oncological control while minimizing functional detriments. The study involved a retrospective review of patients who underwent focal cryoablation at Duke University from 2005 to 2020, with a minimum follow-up of three years. The primary outcomes assessed were failure-free survival (FFS), cancer-specific survival (CSS), metastasis-free survival (MFS), overall survival (OS), and metastasis/cancer-specific death. Secondary outcomes focused on functional aspects, including the International Prostate Symptom Score (IPSS) and the preservation of erectile function, measured at 12 months post-treatment. Of the 70 patients included, with a median age of 75 years, the 5-year FFS was 84%, and the 10-year FFS was 58%. At 10 years, MFS, CSS, and OS rates were 94%, 98%, and 88%, respectively. Regarding functional outcomes, 73% of patients who were initially potent maintained erections sufficient for sexual intercourse, and 97% remained continent without requiring pads. These results demonstrate that focal cryoablation provides excellent long-term oncological control and preserves key functional aspects like erectile function and continence. Focal ablation is a viable option for patients with localized PCa who wish to avoid the side effects associated with more aggressive treatments and maintain a high quality of life.