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Focal Cryotherapy for Localized Prostate Cancer.
1Division of Urology. Department of Surgery. Duke University. Durham. North Carolina. United States of America.
Archivos Espanoles De Urologia
|July 15, 2016
Summary
Focal cryotherapy for localized prostate cancer offers good oncological outcomes and preserves sexual and urinary function. Accurate patient selection is crucial for maximizing the effectiveness of this minimally invasive treatment.
Area of Science:
- Urology
- Oncology
- Minimally Invasive Surgery
Background:
- Focal therapy is an evolving approach for localized prostate cancer.
- Cryotherapy is a focal treatment modality with potential benefits for organ preservation.
Purpose of the Study:
- To systematically review oncological and functional outcomes of primary prostate focal cryotherapy.
- To evaluate contemporary data in the context of advancements in prostate focal therapy.
Main Methods:
- Systematic literature search of PubMed, Cochrane, and Embase databases.
- Inclusion of studies on focal ablation, hemi-ablation, and partial prostate ablation for primary prostate cancer.
- Exclusion of salvage focal therapy studies.
Main Results:
- 1,595 men treated with focal cryotherapy (52% low-risk, 38% intermediate-risk, 10% high-risk).
- Biased-free survival (BPFS) ranged from 71-98%; post-treatment biopsy positivity was 8-25%.
- Continence rates were 96-100%; erectile dysfunction ranged from 0-42%; urinary retention 0-15%.
Conclusions:
- Primary focal cryotherapy is a safe treatment for localized prostate cancer.
- Good preservation of sexual and urinary function is achieved.
- Accurate cancer localization and risk stratification are key for patient selection and achieving short-to-medium term oncological efficacy.
