Current state of image-guided focal therapy for prostate cancer

Tourinho-Barbosa R. R., Wood B. J., Abreu A. L., Nahar B., Shin T., Guven S., ...Daha Fazla

World Journal of Urology, cilt.39, sa.3, ss.701-717, 2021 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 39 Sayı: 3
  • Basım Tarihi: 2021
  • Doi Numarası: 10.1007/s00345-020-03254-4
  • Dergi Adı: World Journal of Urology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, EMBASE, Gender Studies Database, MEDLINE
  • Sayfa Sayıları: ss.701-717
  • Anahtar Kelimeler: Prostate cancer, Ablation techniques, Focal therapy, Localized, Outcome
  • İstanbul Medipol Üniversitesi Adresli: Evet

Özet

Purpose: To review the current evidence regarding protocols and outcomes of image-guided focal therapy (FT) for prostate cancer (PCa). Methods: A literature search of the latest published studies assessing primary FT for PCa was carried out in Medline and Cochrane library databases followed by a critical review. FT modalities, follow-up strategies, and oncological and toxicity outcomes were summarized and discussed in this review. Results: Twenty-four studies with six different sources of energy met the inclusion criteria. A heterogeneity of patient selection, energy sources, treatment templates, and definitions of failure was found among the studies. While a third of patients may be found to have additional cancer burden over 3–5 years following FT, most patients will remain free of a radical procedure. The vast majority of patients maintain urinary continence and good erectile function after FT. Acute urinary retention is the most common complication, whilst severe complications remain rare. Conclusion: An increasing number of prospective studies with longer follow-up have been recently published. Acceptable cancer control and low treatment toxicity after FT have been consistently reported. Follow-up imaging and routine biopsy must be encouraged post-FT. While there is no reliable PSA threshold to predict failure after FT, reporting post-FT positive biopsies and retreatment rates appear to be standard when assessing treatment efficacy.