ArticleWorld journal of urology2026
Cancer-specific mortality in high-risk or very high-risk prostate cancer patients treated with cryotherapy vs. external beam radiation therapy.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCryotherapy in high-risk or very high-risk prostate cancer (PCa) is not guidelines recommended, but it is occasionally used outside of formal clinical trials. However, its effect on cancer-specific mortality (CSM) relatively to standard treatment options such as external beam radiation therapy (EBRT) is unknown and was addressed in the current study.
methodsIn the Surveillance, Epidemiology, and End Results (SEER) database (2010-2022), high-risk or very high-risk PCa patients according to the National Comprehensive Cancer Network (NCCN) guidelines, treated with either cryotherapy or EBRT were identified. Univariable competing risks regression (CRR) models, after 1:1 propensity score matching (PSM), tested for CSM differences after accounting for other-cause mortality (OCM) as a competing event.
resultsOverall, 33,961 high-risk or very high-risk PCa patients treated with cryotherapy or EBRT were identified. Of those, 245 (0.7%) underwent cryotherapy and 33,716 (99.3%) EBRT. In 1:1 PSM, 245 cryotherapy patients were matched with one EBRT control. After 1:1 PSM, at 120-months of follow-up, CSM after EBRT was 7.7% vs. 16.7% after cryotherapy. The corresponding OCM rates were 32.2% after EBRT vs. 32.1% after cryotherapy. In univariable CRR models, accounting for OCM, cryotherapy increased CSM in a 2.2-fold fashion (HR: 2.20; 95% CI: 1.15-4.17; p = 0.017).
conclusionDespite lack of guidelines endorsement, occasional high-risk or very high-risk PCa patients are treated with cryotherapy at large. Population-based observations indicate that cryotherapy is associated with a higher risk of CSM compared with EBRT in these patients.
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