Cryoablation of Prostate- Improving Efficacy and Safety
Main Article Content
Abstract
Cryoablation has been shown to be an effective therapy for all stages of prostate cancer. Though judged efficacious, complications of treatment and persistent disease, although minimal, show the need for improvement. To this end, research has focused on new technology design for cryosurgical apparatus and imaging techniques. Adjunctive therapy, focusing on increasing cell death by apoptosis, also plays a role in this new direction with the intent of increasing cell death in the frozen tissue. Additionally, incorporating methods of protecting adjacent structures, including the urethra, bladder neck sphincter, urogenital diaphragm, neurovascular bundles, and rectum, are critical to achieving a successful outcome and continue to evolve. Several strategies to protect these structures are now commonplace as part of a cryosurgical procedure. These strategies include real-time temperature monitoring, visualization of ice growth during freezing, active heating and even the injection of protective media have emerged as methods to protect these structures. Another more recent procedural application is partial gland ablation or image-targeted focal therapy, developed to maintain cancer control yet minimize the risk of collateral damage to the various structures. Each of these methods has been shown in vitro, in vivo, and clinically to be beneficial. This article describes the directions that cryoablation has taken in an effort to improve procedural efficacy while reducing/eliminating associated co-morbidities.
Keywords:
Cryosurgery, focal therapy, co-morbidity, Temperature Monitoring, Nerve Sparing, apoptosis, cryotherapy, neuroprotection, selective protection
Article Details
How to Cite
BAUST, J. M. et al.
Cryoablation of Prostate- Improving Efficacy and Safety.
Medical Research Archives, [S.l.], v. 8, n. 5, may 2020.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/2106>. Date accessed: 20 apr. 2024.
doi: https://doi.org/10.18103/mra.v8i5.2106.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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3. Bahn, D. K., Lee, F., Badalament, R., Kumar, A., Greski, J., and Chernick, M. Targeted cryoablation of the prostate: 7-year outcomes in the primary treatment of prostate cancer. Urology.2002; 60 (2 Suppl 1). 3-11.
4. Long, J. P., Bahn, D., Lee, F., Shinohara, K., Chinn, D. O., and Macaluso, J. N. Jr. Five-year retrospective, multi-institutional pooled analysis of cancer-related outcomes after cryosurgical ablation of the prostate. Urology.2001; 57 (3). 518-523.
5. Prepelica, K. L., Okeke, Z., Murphy, A., and Katz, A. E. Cryosurgical ablation of the prostate: high risk patient outcomes. Cancer.2005; 103 (8). 1625-1630.
6. Touma, N. J., Izawa, J. I., and Chin, J. L. Current status of local salvage therapies following radiation failure for prostate cancer. J Urol.2005; 173 (2). 373-379.
7. Mouraviev, V. and Polascik, T. J. Update on cryotherapy for prostate cancer in 2006. Curr Opin Urol.2006; 16 (3). 152-156.
8. Peters M, Moman MR, van der Poel HG, Vergunst H, de Jong IJ, Vijverberg PL, Battermann JJ, Horenblas S, van Vulpen M. Patterns of outcome and toxicity after salvage prostatectomy, salvage cryosurgery and salvage brachytherapy for prostate cancer recurrences after radiation therapy: a multi-center experience and literature review. World J Urol. 2013; 31(2):403-9.
9. Finley DS, Belldegrun AS. Salvage cryotherapy for radiation-recurrent prostate cancer: outcomes and complications. Curr Urol Rep. 2011; 12(3):209-15.
10. Mouraviev V, Johansen TE, Polascik TJ. Contemporary results of focal therapy for prostate cancer using cryoablation. J Endourol. 2010; 24(5):827-34.
11. Witzsch UK, Becht E. Cryoablation of prostate cancer. Urologe A. 2015; 54(2):191-201.
12. Kongnyuy M, Halpern DM, Kosinski KE, Katz AE. Cryosurgery, an alternative treatment option for organ-confined prostate cancer: current beliefs and practice patterns of urologists. Int Urol Nephrol. 2017; 49(1):43-48.
13. Stokes, S.H. Comparison of biochemical disease-free survival of patients with localized carcinoma of the prostate undergoing radical prostatectomy, transperineal ultrasound-guided radioactive seed implantation, or definitive external beam irradiation. International Journal of Radiation Oncology, Biology, Physics. 47 (1): 129-136. 2000
14. D'Amico AV, Whittington R, Malkowicz SB, Cote K, Loffredo M, Schultz D, Chen MH, Tomaszewski JE, Renshaw AA, Wein A, Richie JP. Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era. Cancer. 2002 Jul 15;95(2):281-6
15. Fiveash JB, Hanks G, Roach M, Wang S, Vigneault E, McLaughlin PW, Sandler HM. 3D conformal radiation therapy (3DCRT) for high grade prostate cancer: a multi-institutional review. Int J Radiat Oncol Biol Phys. 2000 May 1;47(2):335-42.
16. Hanks GE, Hanlon AL, Schultheiss TE, Freedman GM, Hunt M, Pinover WH, Movsas B. Conformal external beam treatment of prostate cancer. Urology. 1997 Jul;50(1):87-92.
17. Stokes SH. Comparison of biochemical disease-free survival of patients with localized carcinoma of the prostate undergoing radical prostatectomy, transperineal ultrasound-guided radioactive seed implantation, or definitive external beam irradiation. Int J Radiat Oncol Biol Phys. 2000 Apr 1;47(1):129-36.
18. Ragde H, Blasko JC, Grimm PD, Kenny GM, Sylvester JE, Hoak DC, Landin K, Cavanagh W Interstitial iodine-125 radiation without adjuvant therapy in the treatment of clinically localized prostate carcinoma. Cancer. 1997 Aug 1;80(3):442-53.
19. Ritch, C. R. and Katz, A. E. Prostate cryotherapy: current status. Curr Opin Urol.2009; 19 (2). 177-181.
20. Baust, JM, Rabin, Polascik, T, Santucci, KL, Snyder, KK, Van Buskirk, RG and Baust, JG. Review Paper: Defeating cancers' adaptive defensive -strategies using thermal ablative therapies. Technol. Cancer Res. Treat. 2018; 17:1-16.
21. Baust JG, Gage AA, Bjerklund Johansen TE, Baust JM. Mechanisms of cryoablation: Clinical consequences on malignant tumors. Cryobiology. 2014; 68(2):1-11.
22. Baust, J. G. and Gage, A. A. The molecular basis of cryosurgery. BJU Int.2005; 95 (9). 1187-1191.
23. Baust, J. G., Gage, A. A., Klossner, D., Clarke, D., Miller, R., Cohen, J., Katz, A., Polascik, T., Clarke, H., and Baust, J. M. Issues critical to the successful application of cryosurgical ablation of the prostate. Technol Cancer Res Treat.2007; 6 (2). 97-109.
24. Gage, A. A. and Baust, J. Mechanisms of tissue injury in cryosurgery. Cryobiology.1998; 37 (3). 171-186.
25. Klossner, D. P., Robilotto, A. T., Clarke, D. M., VanBuskirk, R. G., Baust, J. M., Gage, A. A., and Baust, J. G. Cryosurgical technique: assessment of the fundamental variables using human prostate cancer model systems. Cryobiology.2007; 55 (3). 189-199.
26. Gage, A. A. and Baust, J. G. Cryosurgery for tumors. J Am Coll Surg.2007; 205 (2). 342-356.
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