Vladimir Mouraviev1, Thomas J Polascik. 1. Division of Urologic Surgery and Duke Prostate Center, Department of Surgery, Duke University Medical Center, 3116 North Duke Street, Durham, NC 27704, USA.
Abstract
PURPOSE OF REVIEW: With the recent introduction of novel, minimally invasive procedures for the treatment of prostate cancer, cryotherapy has become a feasible option as a viable alternative to traditional radical surgery and radiation therapy. In this review we update recent data concerning the basic science of cryobiology, technical trends, oncologic results and complications of this procedure. RECENT FINDINGS: As a result of better understanding of tumor cryodestruction at a molecular level, refinements in cryotechniques and improved patient selection, the results of cryotherapy are becoming more promising. Furthermore, the dramatic decrease in the number of complications after modern cryotherapy leads to a better quality of life, which may be a preferable option, especially for elderly patients with comorbidities. Current trends towards nerve-sparing and focal cryoablation are also discussed. Recent advances in cryobiology open up new opportunities to apply cryotherapy in combination with chemotherapy or radiotherapy for patients with intermediate or high-risk cancers. SUMMARY: Potential directions for future developments in cryosurgery include concepts to reduce side effects such as minimizing cryodamage of the neurovascular bundles (nerve-sparing procedure), and focal ablation of a specific tumor site in patients in whom saturation biopsy supports unifocal prostate cancer.
PURPOSE OF REVIEW: With the recent introduction of novel, minimally invasive procedures for the treatment of prostate cancer, cryotherapy has become a feasible option as a viable alternative to traditional radical surgery and radiation therapy. In this review we update recent data concerning the basic science of cryobiology, technical trends, oncologic results and complications of this procedure. RECENT FINDINGS: As a result of better understanding of tumor cryodestruction at a molecular level, refinements in cryotechniques and improved patient selection, the results of cryotherapy are becoming more promising. Furthermore, the dramatic decrease in the number of complications after modern cryotherapy leads to a better quality of life, which may be a preferable option, especially for elderly patients with comorbidities. Current trends towards nerve-sparing and focal cryoablation are also discussed. Recent advances in cryobiology open up new opportunities to apply cryotherapy in combination with chemotherapy or radiotherapy for patients with intermediate or high-risk cancers. SUMMARY: Potential directions for future developments in cryosurgery include concepts to reduce side effects such as minimizing cryodamage of the neurovascular bundles (nerve-sparing procedure), and focal ablation of a specific tumor site in patients in whom saturation biopsy supports unifocal prostate cancer.
Authors: John M Baust; Daniel P Klossner; Anthony Robilotto; Robert G Vanbuskirk; Andrew A Gage; Vladimir Mouraviev; Thomas J Polascik; John G Baust Journal: BJU Int Date: 2011-08-26 Impact factor: 5.588
Authors: Graham Sommer; Donna Bouley; Harcharan Gill; Bruce Daniel; Kim Butts Pauly; Chris Diederich Journal: Can J Urol Date: 2013-04 Impact factor: 1.344
Authors: Farid G Mitri; Brian J Davis; Azra Alizad; James F Greenleaf; Torrence M Wilson; Lance A Mynderse; Mostafa Fatemi Journal: IEEE Trans Biomed Eng Date: 2008-11 Impact factor: 4.538
Authors: J G Baust; D P Klossner; R G Vanbuskirk; A A Gage; V Mouraviev; T J Polascik; J M Baust Journal: Prostate Cancer Prostatic Dis Date: 2010-01-12 Impact factor: 5.554