Korean J Urol.  2014 Dec;55(12):780-788. 10.4111/kju.2014.55.12.780.

Current Status of Cryotherapy for Prostate and Kidney Cancer

• Cho S
• Kang SH

• KMID: 2070091
• DOI: http://doi.org/10.4111/kju.2014.55.12.780

Abstract

In terms of treating diseases, minimally invasive treatment has become a key element in reducing perioperative complications. Among the various minimally invasive treatments, cryotherapy is often used in urology to treat various types of cancers, especially prostate cancer and renal cancer. In prostate cancer, the increased incidence of low-risk, localized prostate cancer has made minimally invasive treatment modalities an attractive option. Focal cryotherapy for localized unilateral disease offers the added benefit of minimal morbidities. In renal cancer, owing to the increasing utilization of cross-sectional imaging, nearly 70% of newly detected renal masses are stage T1a, making them more susceptible to minimally invasive nephron-sparing therapies including laparoscopic and robotic partial nephrectomy and ablative therapies. This article reviews the various outcomes of cryotherapy compared with other treatments and the possible uses of cryotherapy in surgery.

Keyword

Cryotherapy; Kidney; Neoplasm; Prostate

MeSH Terms

Cryosurgery/adverse effects/*methods
Humans
Kidney Neoplasms/*surgery
Male
Minimally Invasive Surgical Procedures/adverse effects/methods
Prostatic Neoplasms/*surgery
Salvage Therapy/methods
Treatment Outcome

Figure

• 

  FIG. 1 (A) Ultrathin 17-gauge third-generation cryoneedles were inserted under transrectal ultrasonography guidance, approximately 1 cm apart from the urethra, 5 mm from the prostate capsule and 1 cm from each other. Up to 5 thermosensors were placed midgland, at the level of the external sphincter, left neurovascular bundle, right neurovascular bundle, and Denonvilliers' fascia. (B) Flexible cystoscopy was performed to ensure that none of the needles had inadvertently pierced the urethra. (C) Two freeze-thaw cycles were performed under transrectal ultrasonography guidance. (D) After the cryoneedles were removed, gentle pressure was applied to the perineum for 2 to 5 minutes to minimize bleeding.

• 

  FIG. 2 A 76-year-old female patient with a 3.9-cm left renal cell carcinoma (RCC) had a history of recent acute myocardial infarction, diabetes mellitus, hypertension, and high American Society of Anesthesiologists score. The figure shows the preoperative computed tomography (CT) scan (A and B) and the decreased size of the treated RCC in the left kidney without a definite viable portion at 3 months (C), 9 months (D), and 36 months (E) after left renal cryoablation by abdominal CT scan.

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