High-intensity focused ultrasound and cryotherapy as salvage treatment in local radio-recurrent prostate cancer.

Background: Salvage high-intensity focused ultrasound (HIFU) and cryotherapy (CRYO) have emerged as interesting alternatives in the treatment of local radio-recurrent prostate cancer. Currently, recommendations concerning the use of CRYO and HIFU in the salvage setting are still evolving.

Aim: The objective of this review was to analyze the results from studies on CRYO and HIFU as salvage treatment in local radio-recurrent prostate cancer.

Materials And Methods: A National Center for Biotechnology Information PubMed search (www.pubmed.gov) was conducted from 1993 to 2011 using medical subject headings 'High-Intensity Focused Ultrasound', 'Cryotherapy', 'Local Radio-Recurrent' and 'Prostate Cancer'.

Results: In the past years, there have been several published series demonstrating promising acceptable morbidity and oncological outcomes in the short term for HIFU and in the intermediate term for CRYO. The introduction of newer-generation devices and technical modifications has facilitated reduction of complications associated with the procedures. As with any salvage treatment, careful patient selection and subsequent follow-up are principal points.

Conclusions: HIFU and CRYO are promising salvage treatments in patients with local radio-recurrent prostate cancer. The risk of significant complications in the salvage setting is higher compared with primary therapy; therefore, the patients must be informed about the risk of complications and the modality of treatment. However, only further evaluation in formal prospective clinical trials will hopefully confirm their role in clinical practice.