Cryosurgical Ablation of Prostate

  • Duke K. Bahn
  • Fred Lee


Since the development of the prostate-specific antigen (PSA) assay and transrectal ultrasonography (TRUS) the incidence of prostate cancer has progressively increased especially during the 1990s. In 1995 it was estimated that 244,000 men in the United States would have been diagnosed with prostate cancer, among whom 40,400 would succumb.1 The main treatment options, radical prostatectomy and radiation therapy, have also shown dramatically increased rates. Although prostatectomy rates increased sixfold between 1984 and 1990 in the United States, it is still controversial as to whether radical prostatectomy improves survival at any stage of prostate cancer.2,3 There is also a significant increase in the use of radiation therapy for men over 70 years of age.4 Patients treated with radiation therapy for clinically localized prostate cancer show significant rates of biochemical and clinical progression.5,6 Because of the limitations of current therapies for prostate cancer, other treatment options are currently being scrutinized and investigated, including watchful waiting, androgen ablation therapy, and cryosurgical ablation. Cryosurgical ablation has potential for treatment of non-organ-contained disease that is not metastatic to nodes or distant sites because the freezing process is not limited by the gland capsule.7 The goal of cryosurgical ablation is local control of the prostate cancer.


Prostate Cancer Radical Prostatectomy Seminal Vesicle Bladder Neck Neurovascular Bundle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Wingo PA, Tong T, Bolden S: Cancer Statistics. 1995. CA 1995; 45: 8–30PubMedCrossRefGoogle Scholar
  2. 2.
    Lu-Yao G, McLerran D, Wasson J, Wennberg JE. An assessment of radical prostatectomy: time trends, geographic variation, and outcome. JAMA 1993; 269: 2633–2636PubMedCrossRefGoogle Scholar
  3. 3.
    Whitmore WF. Natural history of low stage prostate cancers and the impact of early detection. Urol Clin North Am 1990; 17: 689–697PubMedGoogle Scholar
  4. 4.
    Severson RK, Montie JE, Porter AT, Demers RY. Recent trends in incidence and treatment of prostate cancer among elderly men. J Natl Cancer Inst 1995; 87: 532–534PubMedCrossRefGoogle Scholar
  5. 5.
    Zagars GK. Prostate specific antigen as an outcome variable for T1 and T2 prostate cancers treated by radiation therapy. J Urol 1994; 152: 1786–1791PubMedGoogle Scholar
  6. 6.
    Stamey TA, Ferrari MK, Schmid HP. The value of serial prostate specific antigen determinations 5 years after radiotherapy; steeply increasing values characterize 80 percent of patients. J Urol 1993; 150: 1856–1859PubMedGoogle Scholar
  7. 7.
    Lee F, Bahn DK, McHugh TA, et al. US-guided percutaneous cryoablation of prostate cancer. Radiology 1994; 192: 769–776PubMedGoogle Scholar
  8. 8.
    Gonder M, Soanes W, Shulman S. Cryosurgical treatment of the prostate. Invest Urol 1966; 3: 372–378PubMedGoogle Scholar
  9. 9.
    Onik GM, Cohen JK, Reyes GD, et al. Transrectal ultrasound-guided percutaneous radical cryosurgical ablation of the prostate. Cancer 1993; 72: 1291–1298PubMedCrossRefGoogle Scholar
  10. 10.
    Miller RJ, Cohen JK, Merlottiø LA. Percutaneous transperineal cryosurgical ablation of the prostate for the primary treatment of clinical stage C adenocarcinoma of the prostate. Urology 1994; 44: 170–174PubMedCrossRefGoogle Scholar
  11. 11.
    Bahn DK, Lee GF, Soloman MH, et al. Prostate cancer: US-guided percutaneous cryoablation. Radiology 1995; 194: 551–556PubMedGoogle Scholar
  12. 12.
    Lee F, Littrup PJ, McLeary RD, et al. Needle aspiration and core biopsy of prostate cancer: comparative evaluation with biplanar transrectal US guidance. Radiology 1987; 163: 515–520PubMedGoogle Scholar
  13. 13.
    Lee F, Siders DM, Torp-Pederson ST, et al. Prostate cancer: transrectal ultrasound and pathology comparison—a preliminary study of outer gland (peripheral and central zones) and inner gland (transition zone) cancer. Cancer 1991; 67(Suppl): 1132–1142PubMedCrossRefGoogle Scholar
  14. 14.
    Terris MK, McNeal JE, Freiha FS, Stameyø TA. Efficacy of transrectal ultrasound guided seminal vesicle biopsies in the detection of seminal vesicle invasion by prostate cancer. J Urol 1993; 149: 1035–1039PubMedGoogle Scholar
  15. 15.
    Villers A, McNeal JE, Redwine EA, et al. The role of perineural space invasion in the local spread of prostatic adenocarcinoma.J Urol 1989,142: 763–768PubMedGoogle Scholar
  16. 16.
    Wolf JSJr, Shinohara K, Kerlikowske KM, et al. Selection of laparoscopic pelvic lymphadenectomy prior to radical prostatectomy: a decision analysis. Urology 1993; 42: 680–688PubMedCrossRefGoogle Scholar
  17. 17.
    Lee F Jr, Lee F, et al. Cryoablation of canine prostate. Presented at the Third Midwest Symposium on Prostate Cancer, April 1995, DetroitGoogle Scholar
  18. 18.
    Lee F, Siders DB, Newby JB, et al. The role of transrectal ultrasound-guided staging biopsy and androgen ablation therapy prior to radical prostatectomy. Clin Invest Med 1993; 16: 463–483Google Scholar
  19. 19.
    Pinault S, Tetu B, Glagnon J, et al. Transrectal ultrasound evaluation of local prostate cancer in patients treated with LHRH agonist and in combination with flutamides. Urology 1992; 39: 254–261PubMedCrossRefGoogle Scholar
  20. 20.
    Gage A. Cryosurgery in the treatment of cancer. Surg Gynecol Obstet 1992; 174: 73–92PubMedGoogle Scholar
  21. 21.
    Villers A, McNeal JE, Freihas FS, et al. Invasion of De-onvilliers’ fascia in radical prostatectomy specimens. J Urol 1993; 149: 793–798PubMedGoogle Scholar
  22. 22.
    Chang ZH, Finkelstein JJ, Baust JG. Optimization of cryosurgical instrumentation for use in minimally invasive prostate surgery. AMD 1993; 267: 45–55Google Scholar
  23. 23.
    Onik GM, Cobb C, Zabkar J, Porterfield B. US characteristics of frozen prostate. Radiology 1988; 168: 629–631PubMedGoogle Scholar
  24. 24.
    Trumble TE, Whalen JT. The effect of cryosurgery and cryoprotectants on peripheral nerve function. J Reconstr Microsurg 1992; 8: 53–58PubMedCrossRefGoogle Scholar
  25. 25.
    Cox RL, Carwford ED. Complications of cryosurgical ablation of the prostate to treat localized adenocarcinoma of the prostate. Urology 1995; 45: 932–935PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Duke K. Bahn
  • Fred Lee

There are no affiliations available

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