Role of Image-Guided Focal Cryoablation in Localized Prostate Cancer
Main Article Content
Abstract
Prostate cancer is the most common non-cutaneous malignancy in men, with the majority of newly diagnosed clinical scenarios eligible for active surveillance. However, there may be psychological ramifications associated with living with an untreated malignancy. Furthermore, recent reports show long-term progression exceeds 50% even for low-risk disease. Given the morbidity of traditional whole-gland prostate cancer therapies further advancements are necessary to maximize cure and minimize treatment side effects. Advances in multiparametric MRI has enabled a paradigm shift not only in the detection of clinically significant disease, but also toward more specific disease localization. While traditional treatments for prostate cancer involve whole-gland treatment, contemporary MRI technology allows for consideration of focal ablation via various technologies. This review details focal cryoablation for primary and salvage prostate cancer treatments and compares its efficacy to other treatment methods, including brachytherapy, external beam radiation, and high intensity focused ultrasound. The use of focal cryoablation as a primary treatment has shown promising oncologic outcomes, similar to that of whole-gland cryoablation, but with better functional outcomes. Focal cryotherapy as a salvage treatment has mixed results regarding efficacy and warrants further study. When compared to other focal treatments, cryotherapy leads to similar, or better, oncologic control outcomes. In addition, the review details the considerations for adjunct therapies and future applications to enhance the precision accuracy of current focal cryoablation techniques.
Article Details
How to Cite
FULLER, Renee E. et al.
Role of Image-Guided Focal Cryoablation in Localized Prostate Cancer.
Medical Research Archives, [S.l.], v. 11, n. 12, dec. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4880>. Date accessed: 22 dec. 2024.
doi: https://doi.org/10.18103/mra.v11i12.4880.
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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2. Timilshina N, Alibhai SM, Tomlinson G, Sander B, Cheung DC, Finelli A. Long-term outcomes following active surveillance of low-grade prostate cancer: A population-based study using a landmark approach. J Urol. 2023;209(3):540-548. doi:10.1097/ju.0000000000003097
3. Hamdy FC, Donovan JL, Lane JA, et al. Fifteen-year outcomes after monitoring, surgery, or radiotherapy for prostate cancer. N Engl J Med. 2023;388(17):1547-1558. doi:10.1056/nejmoa2214122
4. Marien A, Gill I, Ukimura O, Nacim B, Villers A. Target ablation—image-guided therapy in prostate cancer. Urol Oncol: Semin Orig. 2014;32(6):912-923. doi:10.1016/j.urolonc.2013.10.014
5. Khan A, Khan AU, Siref L, Feloney M. Focal cryoablation of the prostate: Primary treatment in 163 patients with localized prostate cancer. Cureus. 2023;15(4):e37172. doi:10.7759/cureus.37172
6. Bloom JB, Gold SA, Hale GR, et al. “Super-active surveillance”: MRI ultrasound fusion biopsy and ablation for less invasive management of prostate cancer. Gland Surg. 2018;7(2):166-187. doi:10.21037/gs.2018.03.06
7. Ward JF, Jones JS. Focal cryotherapy for localized prostate cancer: A report from the National Cryo on-line database (cold) registry. BJU Int. 2012;109(11):1648-1654. doi:10.1111/j.1464-410x.2011.10578.x
8. Tan WP, Wysock JS, Lepor H. Partial gland cryoablation for prostate cancer — Where are we? Nat Rev Urol. 2023;20(3):127-128. doi:10.1038/s41585-022-00685-z
9. Arcot R, Potts BA, Polascik TJ. Focal cryoablation of image-localized prostate cancer. J Endourol. 2021;35(S2):S17-S23. doi:10.1089/end.2021.0411
10. Sonn GA, Margolis DJ, Marks LS. Target detection: magnetic resonance imaging-ultrasound fusion-guided prostate biopsy. Urol Oncol. 2014;32(6):903-911. doi:10.1016/j.urolonc.2013.08.006
11. Valerio M, Shah TT, Shah P, et al. Magnetic resonance imaging-transrectal ultrasound fusion focal cryotherapy of the prostate: A prospective development study. Urol Oncol: Semin Orig. 2017;35(4): 150.e1-150.e7. doi:10.1016/j.urolonc.2016.11.008
12. Priester A, Natarajan S, Khoshnoodi P, et al. Magnetic resonance imaging underestimation of prostate cancer geometry: Use of patient specific molds to correlate images with whole Mount Pathology. J Urol. 2017;197(2):320-326. doi:10.1016/j.juro.2016.07.084
13. Littrup PJ, Jallad B, Vorugu V, et al. Lethal isotherms of cryoablation in a phantom study: Effects of heat load, probe size, and number. J Vasc Interv Radiol. 2009;20(10):1343-1351. doi:10.1016/j.jvir.2009.05.038
14. Shah TT, Arbel U, Foss S, et al. Modeling cryotherapy ice ball dimensions and isotherms in a novel gel-based model to determine optimal cryo-needle configurations and settings for potential use in clinical practice. Urology. 2016;91:234-240. doi:10.1016/j.urology.2016.02.012
15. de Marini P, Cazzato RL, Garnon J, et al. Percutaneous MR-guided prostate cancer cryoablation technical updates and literature review. BJR Open. 2019;1(1):20180043. doi:10.1259/bjro.20180043
16. Selvaggio O, Falagario UG, Bruno SM, et al. Intraoperative digital analysis of ablation margins (DAAM) by fluorescent confocal microscopy to improve partial prostate gland cryoablation outcomes. Cancers. 2021;13(17):4382. doi:10.3390/cancers13174382
17. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Guideline Name V.4.2023. © National Comprehensive Cancer Network, Inc. 20XX. All rights reserved. Accessed [July 27, 2023]. To view the most recent and complete version of the guideline, go online to NCCN.org.
18. Chierigo F, Flammia RS, Sorce G, et al. The association of type and number of high‐risk criteria with cancer specific mortality in prostate cancer patients treated with radiotherapy. Prostate. 2023;83(7):695-700. doi:10.1002/pros.24505
19. Fernández-Pascual E, Manfredi C, Martín C, et al. mpMRI-US fusion-guided targeted cryotherapy in patients with primary localized prostate cancer: A prospective analysis of oncological and functional outcomes. Cancers. 2022;14(12):2988. doi:10.3390/cancers14122988
20. Babaian RJ, Donnelly B, Bahn D, et al. Best practice statement on cryosurgery for the treatment of localized prostate cancer. J Urol. 2008;180(5):1993-2004. doi:10.1016/j.juro.2008.07.108
21. Sullivan KF, Crawford ED. Targeted focal therapy for prostate cancer: a review of the literature. Ther Adv Urol. 2009;1(3):149–159. doi:10.1177/1756287209338708
22. Rodríguez SA, Arias Fúnez F, Bueno Bravo C, et al. Cryotherapy for primary treatment of prostate cancer: Intermediate term results of a prospective study from a single institution. Prostate Cancer. 2014;2014:1-11. doi:10.1155/2014/571576
23. Roach M 3rd, Hanks G, Thames H Jr, et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys. 2006;65(4):965-974. doi:10.1016/j.ijrobp.2006.04.029
24. Eastham JA, Auffenberg GB, Barocas DA, et al. Clinically localized prostate cancer: AUA/ASTRO guideline, part I: Introduction, risk assessment, staging, and risk-based management. J Urol. 2022;208(1):10-18. doi:10.1097/JU.0000000000002757
25. Cohen JK, Miller RJ, Ahmed S, Lotz MJ, Baust J. Ten-year biochemical disease control for patients with prostate cancer treated with cryosurgery as primary therapy. Urology. 2008;71(3):515-518. doi:10.1016/j.urology.2007.09.059
26. Kovac E, ElShafei A, Tay KJ, et al. Five-year biochemical progression-free survival following salvage whole-gland prostate cryoablation: defining success with nadir prostate-specific antigen. J Endourol. 2016;30(6):624-631. doi:10.1089/end.2015.0719
27. Durand M, Barret E, Galiano M, et al. Focal cryoablation: a treatment option for unilateral low‐risk prostate cancer. BJU Int. 2014;113(1):56-64. doi:10.1111/bju.12370
28. Barqawi AB, Stoimenova D, Krughoff K, et al. Targeted focal therapy for the management of organ confined prostate cancer. J Urol. 2014;192(3):749-753; doi:10.1016/j.juro.2014.03.033
29. Chuang R, Kinnaird A, Kwan L, et al. Hemigland cryoablation of clinically significant prostate cancer: Intermediate-term followup via Magnetic Resonance Imaging guided biopsy. J Urol. 2020;204(5):941-949. doi:10.1097/ju.0000000000001133
30. Tan YG, Law YM, Ngo NT, et al. Patient‐reported functional outcomes and oncological control after primary focal cryotherapy for clinically significant prostate cancer: A Phase II mandatory biopsy‐monitored study. Prostate. 2023;83(8):781–791. doi:10.1002/pros.24517
31. Aker MN, Brisbane WG, Kwan L, et al. Cryotherapy for partial gland ablation of prostate cancer: Oncologic and safety outcomes. Cancer Med. 2023;12(8):9351-9362. doi:10.1002/cam4.5692
32. Oishi M, Gill IS, Tafuri A, et al. Hemigland cryoablation of localized low, intermediate and high risk prostate cancer: Oncologic and functional outcomes at 5 years. J Urol. 2019;202(6):1188-1198. doi:10.1097/JU.0000000000000456
33. Moreira P, Tuncali K, Tempany CM, Tokuda J. The impact of placement errors on the tumor coverage in MRI-guided focal cryoablation of prostate cancer. Acad Radiol. 2021;28(6):841–848. doi:10.1016/j.acra.2020.07.013
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