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Considerations for patient selection for focal therapy.

John F Ward1, Louis L Pisters

  • 1Associate Professor, Department of Urology, The University of Texas, MD Anderson Cancer Center, Houston, TX 77030, USA.

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|December 3, 2013
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Summary

Focal therapy for prostate cancer is an evolving treatment. Patient selection for this approach is complex, considering technology, disease characteristics, and individual patient factors for optimal outcomes.

Keywords:
HIFUMRIablation techniquescryoablationfocal therapyprostatic neoplasmstransrectal ultrasound

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Area of Science:

  • Oncology
  • Urology
  • Medical Technology

Background:

  • Focal therapy for prostate cancer is an emerging treatment modality.
  • Patient selection criteria are currently evolving alongside technological advancements and a deeper understanding of prostate cancer's natural history.

Purpose of the Study:

  • To discuss the evolving patient selection criteria for focal therapy in prostate cancer.
  • To highlight the multifaceted considerations necessary for identifying appropriate candidates for focal therapy.

Main Methods:

  • Review of current understanding of focal therapy for prostate cancer.
  • Analysis of factors influencing patient selection, including biopsy techniques, imaging modalities, disease location, and patient health.
  • Consideration of therapeutic goals in defining candidate suitability.

Main Results:

  • Patient selection for focal therapy is not solely based on cancer grade or biopsy core count.
  • Criteria are flexible and depend on therapeutic intent, requiring a comprehensive assessment.

Conclusions:

  • Optimal patient selection for focal therapy necessitates a nuanced approach.
  • Factors such as biopsy method (transrectal vs. transperineal mapping), imaging (multiparametric MRI, enhanced ultrasound), anatomical disease location, and patient health/life expectancy are critical.