1300 DOES NEOADJUVANT HORMONE THERAPY PRIOR TO PRIMARY WHOLE GLAND CRYOABLATION OF THE PROSTATE AFFECT OUTCOME

INTRODUCTION AND OBJECTIVES: Cryoablation of the prostate (CAP) has been recognized as a viable treatment option for men with organ-confined prostate cancer. Neoadjuvant hormone therapy (NHT) prior to CAP is sometimes used for prostate volume reduction to facilitate the procedure. NHT has been shown to be beneficial for biochemical disease free survival with radiation therapy, but not in conjunction with radical prostatectomy. We sought to evaluate the affect of NHT on outcomes for primary whole gland CAP using the Cryo On Line Database (COLD) registry. METHODS: Using the COLD registry we retrospectively reviewed men who underwent primary whole gland CAP who were divided into 2 groups based on whether they had received NHT. All patients who had received post-op hormone therapy were excluded. Each group was risk-stratified into 3 cohorts based on DAmico risk criteria: low, intermediate, and high-risk. Freedom from biochemical failure was defined using Phoenix criteria (nadir + 2), and was compared for NHT vs. non-NHT men, and for each of the risk-stratified cohorts. The groups were also compared in terms of post-operative morbidity. RESULTS: 1579 men had NHT prior to CAP and 2342 did not. No differences were found between the NHT group and the non-NHT group in terms of post-operative incontinence, urinary retention, potency, and fistula formation. There was no overall statistical difference in freedom from PSA failure between NHT vs. non-NHT men, 66.9% vs. 66.5% at 5 years. When stratified by D'Amico risk, however, there was a statistical difference between the NHT and non-NHT men only in the intermediate-risk cohort of 74% vs. 66% (p=< 0.013). There was no statistical difference in the low risk group, NHT 83% vs. non-NHT 77% (p=0.59); or in the high risk group, NHT 54% vs. non-NHT 55% (p=0.75). CONCLUSIONS: Freedom from biochemical failure was statistically different between NHT vs. non-NHT men only in the intermediate risk cohort, with an improved biochemical survival for NHT men in this group. No difference was found for incontinence, retention, potency, and fistula formation among men who had received NHT prior to cryoablation.