Cryoablation Combined With Maximal Androgen Blockade For T3 Stage Metastatic Prostate Cancer:Clinical Efficacy And Prognostic Analysis

Object To explore the role of cryoablation therapy in improving the survival prognosis of T3 stage metastatic prostate cancer.Mehtods We conducted a retrospective analysis of 103 patients with T3 stage metastatic prostate cancer clinical data.Those patients were divided into two groups according to treatment methods: Cryoablation combined with Maximal Androgen Blockade(group Cryo+MAB)or Maximal Androgen Blockade only(group MAB).Biochemical Recurrence-Free Survival(b RFS)and Overall Survival(OS)were assessed;Univariate and Cox regression multivariate analyses were also performed.Result The median age of patients was 72 years(range from 56 to 88 years),the median follow-up was 47 months(range from 13 to 97 months).Multivariate analysis showed that Cryoablation,PSA at diagnosed,Gleason score and Time to PSA Nadir(TTPN)were independent factors for OS.Cryoablation,Gleason score,PSA nadir,bone metastasis and Time to PSA Nadir(TTPN)were independent factors for b RFS.Compared with group MAB,group Cryo+MAB prolonged TTPN 3.9 months(11.4 vs.7.5 months,P = 0.026),decreased PSA Nadir 0.72 ng/m L(0.99 ng/m L vs.1.71 ng/m L,P = 0.008),prolonged median OS 29 months(80 months versus 51 months,P < 0.001)and prolonged median b RFS 18 months(30 months vs 12 months,P < 0.001).Subgroup analysis indicated that Compared with group MAB,group Cryo+MAB prolonged median OS 35 months(P < 0.001)in the subgroup with age≥70 years,prolonged median OS 33 months in the subgroup with Gleason score≥8(P = 0.017),prolonged median OS 33 months(P = 0.003)in the subgroup with bone metastasis.Patients either with age<70 years or with Gleason score<8 were all survival in the group Cryo+MAB,statistical difference from group MAB(P=0.022,P=0.001).Conclusion Cryoablation combined with MAB can significantly prolong the TTPN,OS and b RFS of patients with metastatic prostate cancer in T3 stage.Subgroup analysis indicated that patients that PSA<50 ng/m L,any age,any grade Gleason score or combined bone metastases were suitable for the treatment of Cryoablation combined with MAB to improve the prognosis.