Focal therapy for kidney and prostate cancer: Edited by Inderbir S. GillProstate cryotherapy: current statusRitch, Chad R; Katz, Aaron E Author Information Columbia University Medical Center, NY Presbyterian Hospital, Department of Urology, New York, New York, USA Correspondence to Aaron E. Katz, MD, 161 Fort Washington Avenue, Room 1111, New York, NY 10032, USA E-mail: [email protected] Current Opinion in Urology: March 2009 - Volume 19 - Issue 2 - p 177-181 doi: 10.1097/MOU.0b013e32831e16ce Buy Metrics Abstract Purpose of review Minimally invasive options to treat low-risk prostate cancer are more desirable than radical therapy. Technological improvements in cryotherapy have increased its use, and long-term data on its efficacy are emerging. In this review, we discuss contemporary data on cryotherapy with specific focus on studies using the newest technology. Recent findings With respect to biochemical recurrence rates, cryotherapy appears to be as effective for low-risk prostate cancer as other treatment modalities. The definition of recurrence remains problematic, though contemporary studies are more consistently using both the American Society for Therapeutic Radiation Oncology and Phoenix criteria. Erectile dysfunction rates are universally high after whole-gland cryoablation, but incontinence and urethrorectal fistula rates appear to be low with third-generation cryo systems. Focal cryotherapy has encouraging short-term efficacy in terms of biochemical disease-free survival rate for unifocal disease, and rates of erectile dysfunction are dramatically lower than those seen with whole-gland cryoablation. Summary Cryosurgery has a promising role in primary and salvage treatment of select prostate cancer patients. Focal cryotherapy for unilateral disease offers the added benefit of minimal adverse effects. Long-term data are emerging to support cryosurgery, and large multicenter databases have been developed to answer questions regarding optimal treatment outcomes and patterns. © 2009 Lippincott Williams & Wilkins, Inc.