Currently, the choice of tactics of treatment of the patient with
prostate cancer (PCa) requires to take into account the degree of differentiation and stage of
tumor, age of the patient and his somatic diseases, the risk of complications, as well as the patient's desire and physician's experience. Due to the progressive development of medical technology, interest in minimally invasive treatments for
prostate cancer, such as
cryoablation, interstitial
brachytherapy and
HIFU-therapy, has grown.
Cryoablation of the prostate gland is a tissue ablation by local effects of very low temperatures and is minimally invasive, highly effective treatment for
prostate cancer that can be used as the primary treatment, and in the case of
tumor recurrence after
radiotherapy. Focal
cryoablation of the prostate allows to selectively destroy the known
tumor with preservation of organ function and without reducing the quality of life of the patient. Focal
therapy for
prostate cancer is an alternative to radical treatment and active surveillance, occupying an intermediate position between them. Due to the lack of long-term results, focal
cryoablation is an experimental type of treatment. First
cryoablation of the prostate using modern equipment was carried out in Russia in March 2010, at the Department of Urology MSMSU. Since that time, we performed this procedure in 122 patients with
prostate cancer;
cryoablation was primary treatment in 110 patients and was used as
salvage treatment in 12 patients. In most cases, the operation was performed under epidural or
spinal anesthesia. According to the protocol, all the patients underwent 2 cycles of freezing and thawing under transrectal ultrasound guidance. A significant improvement of equipment for
cryosurgery, the use of cryoneedles with smaller diameter, and the use of temperature sensors and
catheters to warm the urethral mucosa have allowed to minimize the number of complications in comparison with other methods of treatment of
prostate cancer and achieve a high disease-free survival. Our prospective study was aimed to analyze our own results
cryoablation of the prostate gland.