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Cryoablation of the prostate: technical recommendations

Abstract

The European Association of Urology guidelines on prostate cancer state that cryotherapy is a true therapeutic alternative for patients with clinically localized prostate cancer. The aim of this paper is to establish a uniform practice for performing prostate cryoablation. A collaboration has been set up among five European centres with experience in almost 1000 prostate cancer patients on the use of cryotherapy. The present recommendations were developed through sharing of experience and thorough discussions within the group. This first paper from the group establishes the technical recommendations for use of prostate cryotherapy.

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References

  1. Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H et al. EAU guidelines on prostate cancer. Eur Urol 2005; 48: 546.

    Article  CAS  PubMed  Google Scholar 

  2. American Urological Association. Best policy statement on the treatment of cryosurgery for the treatment of localized prostate cancer. AUA Annual Meeting, Maryland, 17–22 May 2008.

  3. National Institute of Clinical Excellence. Cryotherapy as a primary treatment for prostate cancer. 2005.

  4. National Institute of Clinical Excellence. Cryotherapy for recurrent prostate cancer. 2005. www.nice.org.uk.

  5. Baust JG, Gage AA . The molecular basis of cryosurgery. BJU Int 2005; 95: 1187.

    Article  PubMed  Google Scholar 

  6. Clarke DM, Baust JM, Van Buskirk RG, Baust JG . Addition of anticancer agents enhances freezing-induced prostate cancer cell death: implications of mitochondrial involvement. Cryobiology 2004; 49: 45.

    Article  CAS  PubMed  Google Scholar 

  7. Tatsutani K, Rubinsky B, Onik G, Dahiya R . Effect of thermal variables on frozen human primary prostatic adenocarcinoma cells. Urology 1996; 48: 441.

    Article  CAS  PubMed  Google Scholar 

  8. Soanes WA, Gonder MJ . Use of cryosurgery in prostatic cancer. J Urol 1968; 99: 793.

    Article  CAS  PubMed  Google Scholar 

  9. EAU guidelines on prostate cancer. http://www.uroweb.org/files/uploaded_files/guidelines/07%20Prostate%20Cancer.pdf

  10. Lane BR, Stein DE, Remzi FH, Strong SA, Fazio VW, Angermeier KW . Management of radiotherapy induced rectourethral fistula. J Urol 2006; 175: 1382.

    Article  PubMed  Google Scholar 

  11. Moreira Jr SG, Seigne JD, Ordorica RC, Marcet J, Pow-Sang JM, Lockhart JL . Devastating complications after brachytherapy in the treatment of prostate adenocarcinoma. BJU Int 2004; 93: 31.

    Article  PubMed  Google Scholar 

  12. Cytron S, Paz A, Kravchick S, Shumalinski D, Moore J . Active rectal wall protection using direct transperineal cryo-needles for histologically proven prostate adenocarcinomas. Eur Urol 2003; 44: 315.

    Article  PubMed  Google Scholar 

  13. Izawa JI, Perrotte P, Greene GF, Scott S, Levy L, McGuire E et al. Local tumor control with salvage cryotherapy for locally recurrent prostate cancer after external beam radiotherapy. J Urol 2001; 165: 86.

    Article  Google Scholar 

  14. Chin JL, Touma N, Pautler SE, Guram KS, Bella AJ, Downey DB et al. Serial histopathology results of salvage cryoablation for prostate cancer after radiation failure. J Urol 2003; 170 (4 Pt 1): 1199.

    Article  PubMed  Google Scholar 

  15. Touma NJ, Izawa JI, Chin JL . Current status of local salvage therapies following radiation failure for prostate cancer. J Urol 2005; 173: 373.

    Article  PubMed  Google Scholar 

  16. Rogers E, Ohori M, Kassabian VS, Wheeler TM, Scardino PT . Salvage radical prostatectomy: outcome measured by serum prostate specific antigen levels. J Urol 1995; 153: 104.

    Article  CAS  PubMed  Google Scholar 

  17. Amling CL, Lerner SE, Martin SK, Slezak JM, Blute ML, Zincke H . Deoxyribonucleic acid ploidy and serum prostate specific antigen predict outcome following salvage prostatectomy for radiation refractory prostate cancer. J Urol 1999; 161: 857.

    Article  CAS  PubMed  Google Scholar 

  18. Ahlering TE, Lieskovsky G, Skinner DG . Salvage surgery plus androgen deprivation for radioresistant prostatic adenocarcinoma. J Urol 1992; 147 (3 Pt 2): 900.

    Article  CAS  PubMed  Google Scholar 

  19. Garzotto M, Wajsman Z . Androgen deprivation with salvage surgery for radiorecurrent prostate cancer: results at 5-year followup. J Urol 1998; 159: 950.

    Article  CAS  PubMed  Google Scholar 

  20. Izawa JI, Madsen LT, Scott SM, Tran JP, McGuire EJ, Von Eschenbach AC et al. Salvage cryotherapy for recurrent prostate cancer after radiotherapy: variables affecting patient outcome. J Clin Oncol 2002; 20: 2664.

    Article  PubMed  Google Scholar 

  21. Katz AE, Ghafar MA . Selection of salvage cryotherapy patients. Rev Urol 2002; 4 (Suppl 2): S18.

    PubMed  PubMed Central  Google Scholar 

  22. De La Taille A, Benson MC, Bagiella E, Burchardt M, Shabsigh A, Olsson CA et al. Cryoablation for clinically localized prostate cancer using an argon-based system: complication rates and biochemical recurrence. BJU Int 2000; 85: 281.

    Article  CAS  PubMed  Google Scholar 

  23. Bahn DK, Lee F, Badalament R, Kumar A, Greski J, Chernick M . Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer. Urology 2002; 60 (2 Suppl 1): 3.

    Article  PubMed  Google Scholar 

  24. Consensus statement. Guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37: 1035.

    Google Scholar 

  25. Shelley M, Wilt TJ, Coles B, Mason MD . Cryotherpay for localised prostate cancer. Cochrane database Syst Rev 2007, July 18(3): CD005010.

  26. Jones JS, Rewcastle JC, Donnelly BJ, Lugnani FM, Pisters LL, Katz AE . Whole gland primary prostate cryoablation: initial results from the cryo on-line data registry. J Urol 2008; 180: 554.

    Article  PubMed  Google Scholar 

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Acknowledgements

This manuscript was supported by an unrestricted educational grant from Galil.

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Correspondence to T E Bjerklund Johansen.

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Key messages: Cryotherapy is a recommended primary treatment for localized prostate cancer and as salvage therapy in prostate cancer patients failing radiotherapy.

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Cytron, S., Greene, D., Witzsch, U. et al. Cryoablation of the prostate: technical recommendations. Prostate Cancer Prostatic Dis 12, 339–346 (2009). https://doi.org/10.1038/pcan.2009.26

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