Authors: V. Mouraviev;  M. Tsivian;  T. J. Polascik
Authors‘ workplace: Associate Professor of Urology, Duke University Medical Center
Published in: Urol List 2009; 7(4): 20-26


Modern cryoablation of the prostate is a constantly developing technique for the definitive treatment of localized prostate cancer that has evolved over three main generations into a safer and more successful therapy nowadays. Technical improvements have occurred secondary to advancements in engineering, procedural refinement, temperature monitoring, and a better understanding of cryobiology at the molecular level. Cryotherapy for prostate cancer has become a feasible option proposed as a viable alternative to traditional radical surgery and radiation therapy.

Key words:
prostate cancer, review, cryoablation, focal therapy


1. Fahmy WE, Bissada NK. Cryosurgery for prostate cancer. Arch Androl 2003; 49(5): 397–407.

2. Zisman A, Leibovici D, Siegel YI et al. Prostate cryoablation without an insertion kit using direct transperineal placement of ultrathin freezing probes. Tech Urol 2000; 6(1): 34–36.

3. Zisman A, Pantuck AJ, Cohen JK et al. Prostate cryoablation using direct transperineal placement of ultrathin probes through a 17-gauge brachytherapy template-technique and preliminary results. Urology 2001; 58(6): 988–993.

4. Cohen J. Cryosurgery of the prostate: techniques and indications. Rev Urol 2004; 6 (Suppl 4): 21–26.

5. Han KR, Cohen JK, Miller RJ et al. Treatment of organ confined prostate cancer with third generation cryosurgery: preliminary multicenter experience. J Urol 2003; 170: 1126–1130.

6. Cooperberg MR, Shinohara K. Prostate cancer: Cryotherapy. 2005.­med/­topic3539.htm.

7. Mouraviev V, Polascik TJ. Update on cryotherapy for prostate cancer in 2006. Curr Opin Urol 2006; 16(3): 152–156.

8. Hoffmann NE, Bischof JC. The cryobiology of cryo­surgical injury. Urology 2002; 60 (2 Suppl 1): 40–49.

9. Bischof JC, Smith D, Pazhayannur PV et al. Cryosurgery of dunning AT-1 rat prostate tumor: thermal, biophysical, and viability response at the cellular and tissue level. Cryobiology 1997; 34(1): 42–69.

10. Hollister WR MA, Baust JG et al. The effects of freezing on cell viability and mechanisms of cell death in an vitro human prostate cancer cell line. Mol Urol 1998; 2: 13-19.

11. Baust JG, Gage AA, Clarke D et al. Cryosurgery--a putative approach to molecular-based optimization. Cryobiology 2004; 48(2): 190–204.

12. Forest V, Peoc'h M, Ardiet C et al. In vivo cryo­chemotherapy of a human lung cancer model. Cryobiology 2005; 51(1): 92–101.

13. Forest V, Peoc'h M, Campos L et al. Effects of cryotherapy or chemotherapy on apoptosis in a non-small-cell lung cancer xenografted into SCID mice. Cryobiology 2005; 50(1): 29–37.

14. Ablin RJ, Soanes WA, Gonder MJ. Immuno-cryo­urogenital treatment of benign and malignant diseases of the prostate. Gerontol Clin (Basel) 1970; 12(5): 302–313.

15. Alblin RJ, Soanes WA, Gonder MJ. Prospects for cryo-immunotherapy in cases of metastasizing carcinoma of the prostate. Cryobiology 1971; 8(3): 271–279.

16. Soanes WA, Ablin RJ, Gonder MJ. Remission of metastatic lesions following cryosurgery in prostatic cancer: immunologic considerations. J Urol 1970; 104(1): 154–159.

17. Mouraviev V, Prochorov G, Ablin R. The combined cytoreductive cryoablation and immunochemotherapy for advanced prostate cancer. Abstracts of 5th World Congress on Advances in Oncology, Rhodes,Greece (October 15-18) (#116). Int.J.Mol.Med 2000; 6, (Suppl.1): 202.

18. Gursel E, Roberts M, Veenema RJ. Regression of prostatic cancer following sequential cryotherapy to the prostate. J Urol 1972; 108(6): 928–932.

19. Drylie DM, Hahn GS. Stimulation of prostatic antibodies by cryosurgery. J Urol 1973; 110(3): 324–325.

20. Hoffmann NE, Coad JE, Huot CS et al. Investi­ga­tion of the mechanism and the effect of cryoimmunology in the Copenhagen rat. Cryobiology 2001; 42(1): 59–68.

21. Milleman LA, Weissman WD, Culp DA. Serum protein, enzyme and immunoglobulin responses follo­wing perineal cryosurgery for carcinoma of the prostate. J Urol 1980; 123(5): 710–711.

22. Hayakawa K, Yamashita T, Suzuki K et al. Comparative immunological studies in rats following cryosurgery and surgical excision of 3-methylcholanthrene-induced primary autochthonous tumors. Gann 1982; 73(3): 462–469.

23. Yamashita T, Hayakawa K, Hosokawa M et al. Enhanced tumor metastases in rats following cryosurgery of primary tumor. Gann 1982; 73(2): 222–228.

24. Ablin R. An appreciation and realization of the concept of cryoimmunology. In Onik G, Rubinsky B, Watson G et al (Eds), Percutaneous Prostate Cryoablation. St.Louis, Quality Medical Publishing, Inc 1995: 136–154.

25. Chao BH, He X, Bischof JC. Pre-treatment inflammation induced by TNF-alpha augments cryosurgical injury on human prostate cancer. Cryobiology 2004; 49(1): 10–27.

26. den Brok MH, Sutmuller RP, Nierkens S et al. Synergy between in situ cryoablation and TLR stimulation results in a highly effective in vivo dendritic cell vaccine. Cancer Res 2006; 66(14): 7285–7292.

27. Baust JG, Gage AA. The molecular basis of cryosurgery. BJU Int 2005; 95(9): 1187–1191.

28. Shen D, Zeng J, Zhang W et al. Optimized prostate biopsy via a statistical atlas of cancer spatial distribution. Med Image Anal 2004. 8(2): 139–150.

29. Prepelica KL, Okeke Z, Murphy A et al. Cryo­surgical ablation of the prostate: high risk patient outcomes. Cancer 2005; 103(8): 1625–1630.

30. Polascik TJ, Nosnik I, Mayes JM et al. Short-term cancer control after primary cryosurgical ablation for clinically localized prostate cancer using third-generation cryotechnology. Urology 2007; 70(1): 117–121.

31. D'Amico AV. Combined-modality staging for localized adenocarcinoma of the prostate. Oncology (Williston Park) 2001; 15: 1049–1059; discussion 1060–1042, 1064–1045, 1069–1070,1073–1045.

32. Robinson JW, Donnelly BJ, Saliken JC et al. Quality of life and sexuality of men with prostate cancer 3 years after cryosurgery. Urology 2002; 60 (2 Suppl 1): 12–18.

33. Mouraviev V, Nosnik I, Sun L et al. Financial comparative analysis of minimally invasive surgery to open surgery for localized prostate cancer: a single-institution experience. Urology 2007; 69(2): 311–314.

34. Anastasiadis AG, Sachdev R, Salomon L et al. Comparison of health-related quality of life and prostate-associated symptoms after primary and salvage cryotherapy for prostate cancer. J Cancer Res Clin Oncol 2003; 129(12): 676–682.

35. Ball AJ, Gambill B, Fabrizio MD et al. Prospective longitudinal comparative study of early health-related quality-of-life outcomes in patients undergoing surgical treatment for localized prostate cancer: a short-term evaluation of five approaches from a single institution. J Endourol 2006; 20(10): 723–731.

36. Huang WC, Kuroiwa K et al. The anatomical and pathological characteristics of irradiated prostate cancers may influence the oncologic efficacy of salvage therapies. J Urol. 2006; 175 (Suppl): 312.

37. Gould RS. Total cryosurgery of the prostate versus standard cryosurgery versus radical prostatectomy: comparison of early results and the role of transurethral resection in cryosurgery. J Urol 1999; 162(5): 1653–1657.

38. Onik G, Narayan P, Vaughan D et al. Focal "nerve-sparing" cryosurgery for treatment of primary prostate cancer: a new approach to preserving potency. Urology 2002; 60(1): 109–114.

39. Janzen NK, Han KR, Perry KT et al. Feasibility of nerve-sparing prostate cryosurgery: applications and limitations in a canine model. J Endourol 2005; 19(4): 520–525.

40. Mouraviev V, Mayes JM, Sun L et al. Prostate cancer laterality as a rationale of focal ablative therapy for the treatment of clinically localized prostate cancer. Cancer 2007; 110(4): 906–910.

41. Cheng L, Jones TD, Pan CX et al. Anatomic distribution and pathologic characterization of small-volume prostate cancer (<0.5 ml) in whole-mount prostatectomy specimens. Mod Pathol 2005; 18(8): 1022–1026.

42. Ohon M EJ, Koh H,Kuroiwa K,Slawin K,Wheeler TM, Scardino PT. Is focal therapy reasonable in patients with early stage prostate cancer (CAP)- an amalysis of radical prostatectomy (RP) specimens. J Urol 2006;175 (Suppl) 507 (Abstract#1574).

43. Barzell WE CR, Melamed MR. The utility of transperineal 3-Dimensional pathological mapping in counseling patients seeking expectant management for low volume prostate cancer. Seventh Annual SUO meeting to discuss current tipiocs and strategies in urologc oncology. Extraodinary opportunities for discovery.Abstract book 2006: 91.

44. Rukstalis DB, Goldknopf JL, Crowley EM et al. Prostate cryoablation: a scientific rationale for future modifications. Urology 2002; 60 (2 Suppl 1): 19–25.

45. Lambert EH, Bolte K, Masson P et al. Focal cryo­surgery: encouraging health outcomes for unifocal prostate cancer. Urology 2007; 69(6): 1117–1120.

46. Bahn DK, Silverman P, Lee F Sr et al. Focal prostate cryoablation: initial results show cancer control and potency preservation. J Endourol 2006; 20(9): 688–692.

47. Onik G. Rationale for a "Male Lumpectomy," a Pros­tate Cancer Targeted Approach Using Cryoablation: Results in 21 Patients with at Least 2 Years of Follow-Up. Cardiovasc Intervent Radiol 2007; 31(1): 98–106.

48. Cresswell J, Asterling S, Chaudhary M et al. Third-generation cryotherapy for prostate cancer in the UK: a prospective study of the early outcomes in primary and recurrent disease. BJU Int 2006; 97: 969–974.

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