{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T07:08:18Z","timestamp":1778742498340,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Prostate"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To report long\u2010term oncologic and functional outcomes of a second therapeutic freeze (STF) after salvage cryoablation (sCryo) for biopsy\u2010proven persistence following radiotherapy for localized prostate cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed 10 men with biopsy\u2010proven local recurrence after sCryo following radiotherapy who underwent a STF. Outcomes were urinary and erectile function (social continence 0\u20131 pad\/day; potency defined as International Index of Erectile Function\u20105 (IIEF\u20105) score \u2265\u200917), complications (Clavien\u2013Dindo classification), and oncologic endpoints: failure\u2010free survival (FFS), metastasis\u2010free survival (MFS), cancer\u2010specific survival (CSS), and overall survival (OS). FFS was defined as the absence of Phoenix biochemical failure, radiographic progression, initiation of systemic therapy, or prostate cancer\u2010specific death. MFS, CSS, and OS were time\u2010to\u2010event endpoints, estimated using Kaplan\u2013Meier methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median follow\u2010up was 77 months (Interquartile range [IQR] 37\u2013133). The median interval between the cryoablations was 22 months (IQR 10\u201333). At 5 years, FFS was 52.5% (95% CI 15.0\u201380.4), MFS was 80.0% (95% CI 40.9\u201394.6), CSS was 87.5% (95% CI 38.7\u201398.1), and OS was 75.0% (95% CI 31.5\u201393.1). Median ADT\/systemic\u2010therapy deferral after STF was 19 months (IQR 9\u201342.5). After STF, 7\/10 men were socially continent; and 6\/10 were pad\u2010free at 1 year. Both men who were potent pre\u2010STF, remained potent. No Clavien\u2013Dindo\u2009\u2265\u2009III complications were attributable to STF, though a rectourethral fistula was observed at 5 months post\u2010STF in a single patient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this limited cohort with intermediate\u2010 to long\u2010term follow\u2010up, STF after prior sCryo preserved genitourinary function and deferred ADT in select men with local recurrence after radiation and sCryo. While oncological outcomes are not equivalent to primary treatment, STF appears to be a feasible and reasonably safe option to extend local control in carefully selected candidates. Larger, prospective studies are needed before broader conclusions can be drawn.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pros.70181","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T19:09:11Z","timestamp":1776280151000},"page":"1028-1034","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Second Therapeutic Freeze After Salvage Cryoablation for Localized Radiorecurrent Prostate Cancer"],"prefix":"10.1002","volume":"86","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8919-2042","authenticated-orcid":false,"given":"Sudharshanan","family":"Balaji","sequence":"first","affiliation":[{"name":"Department of Urology Duke University Medical Center Durham North Carolina USA"},{"name":"Center for Prostate and Urologic Cancers Duke Cancer Institute Durham North Carolina 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