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Title: American Urological Association Releases Best Practice Statement on Cryosurgery
URL: http://www.pslgroup.com/dg/22D3C2.htm
Doctor's Guide
September 22, 2008

NEW YORK -- September 22, 2008 -- The American Urological Association (AUA) has developed a best practice statement regarding the treatment of localised prostate cancer using cryosurgery, which will be published in the November 2008 issue of The Journal of Urology.

The consensus states that primary cryosurgery is an option for men who have clinically organ-confined prostate cancer of any grade with negative metastatic evaluation. Clinicians using cryosurgery are advised to review this best practice statement.

The panel, chaired by Richard J. Babaian, MD, Prostate Cancer Detection Clinic, The University of Texas, M. D. Anderson Cancer Center, Houston, Texas, carefully reviewed findings published in the medical literature from 2000 to 2008, shared their expert opinions and experience treating several thousands of patients, and formulated recommendations. These recommendations were achieved through a rigorous consensus process.

Dr. Babaian and colleagues note that case selection is a primary factor. Larger prostates may make it more difficult to uniformly achieve cold enough temperatures and previous transurethral resection may be a contraindication.

The authors also made recommendations for maximising the results of cryosurgery, such as using rapid freezing thermocouples to monitor temperature and a double freeze cycle, and obtaining a nadir temperature of -40. Complications are outlined based on the available literature.

"In summary, a review of the historical evolution of cryosurgery provides 2 overriding messages, the first being that there is evidence of therapeutic benefit, and the second, that treatment-associated morbidity has been reduced as technological refinements have emerged," the panel wrote.

SOURCE: Elsevier Health Sciences

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