SIR 2024
Interventional Oncology
Koustav Pal, MBBS
Postdoctoral Research Fellow
MD Anderson
Financial relationships: Full list of relationships is listed on the CME information page.
Peiman Habibollahi, MD, RPVI
Assistant Professor
MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
Steven Y. Huang, MD, FSIR
Professor
The University of Texas MD Anderson
Disclosure information not submitted.
Zeyad Metwalli, MD
Assistant Professor
MD Anderson Cancer Center
Disclosure information not submitted.
Steven Yevich, MD MPH
Associate Professor
MD Anderson Cancer Center
Disclosure information not submitted.
Alda Tam, MD, MBA, FSIR
Professor, Department of Interventional Radiology, Division of Diagnostic Imaging
MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
Rahul A. Sheth, MD
Associate Professor
University of Texas MD Anderson Cancer Center
Financial relationships: Full list of relationships is listed on the CME information page.
To retrospectively evaluate the efficacy and safety of percutaneous image-guided cryoablation in the treatment of prostate cancer metastases.
Materials and Methods:
Records collected from the institutional database identified 133 patients who underwent 155 procedures for the treatment of 185 tumors from February 2015 to April 2023. Overall survival (OS), local tumor recurrence-free survival (LPFS), overall progression-free survival (PFS), and procedural complications were analyzed.
Results:
All patients in the study cohort were treated for metastatic disease, and 70% of patients had progressed to castration-resistant prostate cancer (mCRPC). Treated sites included bone (109, 59%), lymph nodes (42, 23%), soft tissue (25, 14%), and lung (9, 4.9%). The median tumor diameter was 2.5 cm (range 0.7 to 12.5 cm). One- and two-year OS rates were 98% and 87%, respectively. LPFS rates at one and two years were 82% and 72%, while overall PFS was 47% at one year and 21% at two years. Stratification by oligometastatic vs. metastatic status revealed a significant survival difference in OS (93% vs. 63% at two years, p< 0.001). On the other hand, LPFS for patients with oligometastatic vs. metastatic disease was not significant (p=0.07). LPFS also showed significant variance when stratified by treated site, with two-year rates of 74% for bone, 54% for lymph nodes, and 70% for soft tissue (p < 0.001). Univariable logistic regression for tumor recurrence showed that age (OR 0.897, 95% CI [0.827-0.974], p=0.009) and lymph nodes (OR 2.88, 95% CI [1.167-7.107], p=0.022) were significant predictors of local tumor recurrence. The complication rate was 4.5%.
Conclusion:
Cryoablation of prostate cancer metastases is a safe and clinically effective procedure with durable treatment efficacy. Considerations regarding sites of treatment can potentially influence local tumor recurrence-free survival.