title: Review of primary and salvage cryoablation for prostate cancer.
abstract: BACKGROUND
  Cryosurgery has gained popularity as a minimally invasive treatment option for primary and recurrent prostate cancer. Herein we present a review and summary reports on primary cryoablation for prostate cancer and salvage cryoablation following radiation failure.
  
  
  METHODS
  We reviewed the current published literature in the English language on these topics, along with some historic articles dating back to the 1960s for background and development of the procedure. The material is supplemented by some commentary based on our own 13-year experience with cryoablation for prostate cancer. The review is divided into two sections: primary and salvage cryoablation.
  
  
  RESULTS
  For primary cryoablation, success rates are proportional to the risk categories of the primary cancers. A pretreatment prostate-specific antigen (PSA) <or= 10 ng/mL and an undetectable PSA nadir following cryoablation are associated with a more favorable long-term outcome. Safety profile and quality of life are acceptable in carefully selected patients. Similarly, for salvage cryoablation following radiation failure, patient selection is of paramount importance. The most consistently identified predictive factors for poor cryoablation outcomes were pre-cryoablation PSA > 10 ng/mL and post-cryoablation nadir PSA > 1 ng/mL for salvage procedures. Side effects are more prevalent and serious than with primary cryoablation but for carefully selected patients, the long-term results are favorable.
  
  
  CONCLUSIONS
  Patient selection is the key to success with cryoablation, in both the primary and salvage setting. The modality can offer long-term cancer control in carefully selected patient with properly executed techniques.
authors.affiliation: Division of Urological Surgery, University of Western Ontario, London, Canada N6A 4G5. joseph.chin@lhsc.on.ca
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Chin
authors.forename: Darwin
authors.initials: D
authors.lastname: Lim
authors.forename: Mazen
authors.initials: M
authors.lastname: Abdelhady
mesh_terms: D003452:Cryosurgery / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D018579:Patient Selection; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000601:surgery*; D011788:Quality of Life; D012307:Risk Factors; D016879:Salvage Therapy; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen