Nerve-sparing focal cryoablation of prostate cancer

Abstract

We evaluate the rationale, candidate selection, and results of the first clinical studies of focal cryoablation for select patients with low volume and low-to-low - moderate risk features of prostate cancer as a possible alternative to whole gland treatment. For a select cohort of patients with low-to-low - moderate risk unifocal or unilateral prostate cancer, a number of ablative treatment options for focal therapy are available with cryotherapy having the most clinical experience. However, retrospective pathological data from large prostatectomy series do not clearly reveal valid and reproducible criteria to select appropriate candidates for focal cryoablation due to the complexity of tumorigenesis in early stage disease. The concept of focal therapy is evolving with the understanding of the biologic variability (clinically aggressive, significant, or insignificant) of prostate cancers that may require different treatment approaches. 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.