AUA Best Practice Summary
Top 10 Conclusions Regarding Cryosurgery for Prostate Cancer
- General Considerations
- Recent technological advances have significantly reduced complication rates
- Minimally invasive, outpatient procedure performed in an average of 2 hours
- Primary Patient Selection
- Organ confined
- Any grade
- Negative metastatic evaluation
- Primary BDFS (5 Years)
- Low risk: 65-92%
- Moderate risk: 69-89%
- High risk: 48-91%
- Primary Negative Biopsy
- 87-98%
- Primary Complications
- Retention: 1-2 weeks
- Swelling: 1-2 weeks
- Numbness: 2-4 months
- Fistula: 0-0.5%
- Incontinence: 1-8%
- ED (12 months): 49-93%
- Sloughing (2000 data): 0-15%
- Salvage Patient Selection
- Organ confined with positive biopsy confirming disease in prostate
- PSA ≤ 10 ng/mL
- Long PSA doubling time
- No evidence of SV invasion
- Life expectancy > 10 years
- Negative metastatic evaluation
- Salvage BDFS (Up to 2 years)
- 34-86%
- Salvage Negative Biopsy
- 93-94%
- Salvage Complications
- Incontinence: <10%
- Fistula: 0-3%
- Rectal pain: 17-37%
- Sloughing: 5-10%
- ED: >80%
- Subtotal: Preliminary data encouraging. Prospective data should be collected for analysis.
