Contemporary results of focal therapy for prostate cancer using cryoablation.
Abstract
The concept of focal therapy is rapidly evolving and gaining popularity from both
physician and patient perspectives. We review the rationale, candidate selection,
and results of the first clinical studies of focal cryoablation for selected patients
with low volume and low- to low-moderate-risk features of prostate cancer as an alternative
to whole-gland treatment. In spite of improved understanding of the tumor biology
of early stage disease, we currently have limited tools to select appropriate patients
with low- to low-moderate risk unifocal or unilateral prostate cancer who may be amenable
to focal therapy. From a technical point, a number of ablative treatment options for
focal therapy are available, with cryoablation having the most clinical experience.
Recently, several reports have been published from single and multi-institutional
studies that discuss focal therapy as a reasonable balance between cancer control
and quality-of-life outcomes. Retrospective pathologic data from large prostatectomy
series, however, do not clearly reveal valid and reproducible criteria to select appropriate
candidates for focal cryoablation because of the complexity of tumorigenesis in early
stage disease. At this time, a more feasible option remains hemiablation of the prostate
with reasonable certainty about the absence of clinically significant cancer lesion(s)
on the contralateral side of the prostate based on three-dimensional transperineal
prostate biopsy mapping studies. Minimally invasive, parenchyma-preserving cryoablation
can be considered as a potential feasible option in the treatment armamentarium of
early stage, localized prostate cancer in appropriately selected candidates. There
is a need to further test this technique in randomized, multicenter clinical trials.
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https://hdl.handle.net/10161/3235Published Version (Please cite this version)
10.1089/end.2009.0546Publication Info
Mouraviev, Vladimir; Johansen, Truls Erik Bjerklund; & Polascik, Thomas J (2010). Contemporary results of focal therapy for prostate cancer using cryoablation. J Endourol, 24(5). pp. 827-834. 10.1089/end.2009.0546. Retrieved from https://hdl.handle.net/10161/3235.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Thomas James Polascik
Professor of Surgery
Prostate cancer imaging Focal therapy of prostate cancer Prostate cancer outcomes
Kidney cancer outcomes Minimally invasive surgery Nerve sparing cryotherapy

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