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Evidence summaries

Cryotherapy for Localised Prostate Cancer

Cryotherapy might possibly offer a potential alternative to standard therapies for the primary treatment of localised prostate cancer, but the evidence is insufficient. Level of evidence: "D"

A Cochrane review [Abstract] 1 included 8 case series studies with a total of 1 483 subjects. In addition, there was one comparative study with 159 patients. No randomised trials were found. In the comparative study, at 6 months the success rates defined as a post-operative PSA of 0.2 ng/mL or less, were reported as 96% for total cryotherapy, 49% for standard cryotherapy, and 73% for radical prostatectomy. In the case-series studies, cryotherapy induced clinical benefits, with 72 to 99% of patients having a negative biopsy post-treatment and progression-free survival ranging from 39% to 89%. At 5 years, overall survival was reported as 89 to 92% in two studies, and disease-specific survival as 94% in one study. The major complications observed in all studies included impotence (47 to 100%), incontinence (1.3 to 19%), and urethral sloughing (3.9 to 85%), with less common complications of fistula (0 to 2%), bladder-neck obstruction (2 to 55%), stricture (2.2 to 17%) and pain (0.4 to 3.1%).

Comment: The quality of evidence is downgraded by study quality (no RCT:s available).

    References

    • Shelley M, Wilt TJ, Coles B, Mason MD. Cryotherapy for localised prostate cancer. Cochrane Database Syst Rev 2007 Jul 18;(3):CD005010. [PubMed]

Primary/Secondary Keywords