Cryotherapy of the Prostate
Cryosurgery represents a recognized option for the treatment of prostate cancer. Herein we discuss the principles of cryobiology and their implications in modern cryosurgery, review the indications for primary and salvage cryotherapy, as well as summarize perioperative, functional, and oncologic outcomes of the procedure. In the primary setting cryoablation achieves biochemical disease-free survival (bDFS) rates as high as 89.9%, whereas in the salvage setting long-term data show a consistent bDFS rate of over 50%. Cryosurgery is a minimally invasive procedure and complications are typically minor and transient in both the primary and salvage settings. Future developments involve targeted focal therapy whereby healthy prostate tissue is spared with potential reduced morbidity and better preservation of quality of life. © 2012 Blackwell Publishing Ltd.