Authors' objectives: This Technote has been prepared in response to a request from Capital Health for an update on the status of cryotherapy for the primary treatment of localized prostate cancer.

Authors' results and conclusions: Information on the efficacy/effectiveness and safety of cryotherapy as a primary treatment for localized prostate cancer was obtained from five case series, all but one retrospective. Scientific evidence from case series is considered to be weak in the hierarchy of evidence. The authors of the studies used different protocols for follow-up biopsies and applied different methods for calculating probabilities of survival. Biopsies were found positive in 12% to 14% of the cases examined after the treatment. Cryotherapy was associated with high rates of impotence (between 47% and 95%) and incontinence (between 1.3% for "severe" incontinence and 15.9% for "any leakage"). Other less prevalent complications were tissue sloughing, urinary retention, and rectal pain. Overall the authors of the case series considered that cryotherapy is a feasible treatment option for localized, confined prostate cancer.

Authors' recommendations: Cryotherapy, when used as primary treatment for localized prostate cancer, is a promising technology based on calculation of 5- to 7-year probability-of-survival rates, reduction of prostate-specific antigen (PSA) values, and biopsy findings. Moreover, the technology continues to evolve in terms of instrumentation and the biology of cryotherapy. The place of cryotherapy among traditional therapies (radical prostatectomy, radiation therapy, and watchful waiting) has yet to be determined by comparative studies. Also, the specific population that would be most appropriate for this therapy has yet to be established.

Authors' methods: Overview

Project Status: Completed

Year Published: 2005

URL for published report: https://www.ihe.ca/advanced-search?type=1020

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Institute of Health Economics

Contact Address: 1200, 10405 Jasper Avenue, Edmonton, Alberta, Canada, T5J 3N4. Tel: +1 780 448 4881; Fax: +1 780 448 0018;

Contact Name: djuzwishin@ihe.ca

Contact Email: djuzwishin@ihe.ca

Copyright: <p>Alberta Heritage Foundation for Medical Research (AHFMR)</p>