Objective: Appropriate therapies for locally confined adenocarcinoma of the prostate are available - but there is as yet no gold standard of therapy. For that reason, old therapeutic regimens are being revised. One such regimen is cryotherapy. Methods: Between 1976 and 1989, 1,250 patients were seen with newly diagnosed prostate cancer. Sixty-six patients of stages T(1c) (n = 3), T(2a)(n = 32), T(2b) (n = 9), T(2c) (n = 11), T(3a) (n = 4), T(3b) (n = 5) and T(3c) (n = 2) were treated by open perineal cryotherapy. Mean age was 68 years. Three months after surgery, transurethral resection of the prostate and/or perineal biopsy was performed. Results: In 66% of patients with stages T(1c)-T(2b) and in 87%of patients with stages T(2c)-T(3c), positive biopsies were obtained. To date, 28 patients have died between 3 and 16 years after cryotherapy, with a mean survival of 7.2 years. The mean follow-up period of survivers (38 patients) is 8.5 years. Complications were: stress-incontinence in 10%, impotence in 10%and temporary rectoperineal fistula in 8%. Conclusions: Cryosurgery is an effective treatment for locally confined prostate cancer. With improvement of the procedure, clinical outcome may also improve.

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