Retrospective Review of Percutaneous Image-Guided Ablation of Oligometastatic Prostate Cancer: A Single-Institution Experience

Purpose: To retrospectively review and report the efficacy and safety of percutaneous image-guided ablation (cryoablation or radiofrequency ablation) in the treatment of oligometastatic prostate cancer. Materials and Methods: An institutional registry was retrospectively reviewed and revealed 16 patients with oligometastatic prostate cancer (median age, 67 y; range, 50-86 y) who underwent percutaneous image-guided ablation to treat 18 metastatic sites. A subgroup of 7 patients with 8 metastases were androgen-deprivation therapy (ADT)-naive and underwent ablation to delay initiation of ADT. Local tumor control, progression-free survival (PFS), ADT-free survival, and procedural complications were analyzed. Results: Local tumor control was achieved in 15 of 18 metastases (83%) at a median follow-up of 27 months (range, 5-56 mo). Local tumor recurrence was found in 3 of 18 metastases (17%), with a median time to local recurrence of 3.5 months (range, 3-38 mo). Estimated PFS rates at 12 and 24 months were 56% (95% confidence interval [CI], 30%-76%) and 43% (95% Cl, 19%-65%), respectively. In the 7 ADT-naive patients, local tumor control was achieved in all metastases, and the median ADT-free survival period was 29 months. There were no major procedural complications. Conclusions: In this cohort of patients with oligometastatic prostate cancer, percutaneous image-guided ablation was feasible and well tolerated and achieved acceptable local tumor control rates. Percutaneous ablation may be of particular utility in patients who wish to delay initiation of ADT.