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)–naïve 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% CI, 19%–65%), respectively. In the 7 ADT-naïve 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.