From whole-gland to targeted cryoablation for the treatment of unilateral or focal prostate cancer.
The intermediate and long-term results of primary full-gland cryoablation for localized prostate cancer with moderate- and high-risk patients suggests a cancer control rate similar to what can be achieved with radiotherapy and surgery, with an acceptable rate of complications. A recent shift in the treatment paradigm toward unilateral cryoablation (hemiablation) or ablation of unifocal lesion(s) in select patients suggests the ability of this approach to maintain a quality of life closer to the pretreatment level. However, trials with longer oncologic follow-up are needed. The development of more accurate imaging-based techniques-ie, image-guided prostate biopsy sampling and image-guided prostate cryoablation-is of paramount importance to selecting appropriate candidates for an organ-sparing procedure. To make this approach scientifically sound, further investigation to establish patient selection criteria, the development of molecular and imaging parameters of cryoablative efficacy, and regular careful follow-up of these patients is needed.
Polascik
Thomas J
TJ
Division of Urologic Surgery, Duke Prostate Center (DPC), Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Mayes
Janice M
JM
Mouraviev
Vladimir
V
D003452:Cryosurgery / Q000379:methods*; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000503:physiopathology / Q000523:psychology / Q000601:surgery*; D011788:Quality of Life; D016896:Treatment Outcome