title: Focal cryotherapy of localized prostate cancer: a systematic review of the literature.
abstract: Radical/whole gland treatment for prostate cancer has significant side-effects. Therefore focal treatments such as cryotherapy have been used to treat localized lesions whilst aiming to provide adequate cancer control with minimal side-effects. We performed a systematic review of Pubmed/Medline and Cochrane databases' to yield 9 papers for primary focal prostate cryotherapy and 2 papers for focal salvage treatment (radio-recurrent). The results of 1582 primary patients showed biochemical disease-free survival between 71-93% at 9-70 months follow-up. Incontinence rates were 0-3.6% and ED 0-42%. Recto-urethral fistula occurred in only 2 patients. Salvage focal cryotherapy had biochemical disease-free survival of 50-68% at 3 years. ED occurred in 60-71%. Focal cryotherapy appears to be an effective treatment for primary localized prostate cancer and compares favorably to radical/whole gland treatments in medium-term oncological outcomes and side-effects. Although more studies are needed it is also effective for radio-recurrent cancer with a low complications rates.
authors.affiliation: Division of Surgery and Interventional Science, University College London, London, UK.
authors.forename: Taimur Tariq
authors.initials: TT
authors.lastname: Shah
authors.forename: Hashim
authors.initials: H
authors.lastname: Ahmed
authors.forename: Abi
authors.initials: A
authors.lastname: Kanthabalan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Lau
authors.forename: Maneesh
authors.initials: M
authors.lastname: Ghei
authors.forename: Barry
authors.initials: B
authors.lastname: Maraj
authors.forename: Manit
authors.initials: M
authors.lastname: Arya
mesh_terms: D002986:Clinical Trials as Topic / Q000379:methods; D017679:Cryotherapy / Q000379:methods* / Q000639:trends; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D016896:Treatment Outcome
keywords: cryoablation; cryobiology; cryoimmunology; cryotherapy; focal therapy; minimally invasive treatment; prostate cancer