New technologies and techniques for prostate cancer focal therapy

Area of Science:

• Urology
• Oncology
• Medical Technology

Background:

• Localized prostate cancer (PCa) management involves various treatment modalities.
• Focal treatments (FT) offer a less invasive approach to treating PCa.
• Evaluating the efficacy and safety of primary focal therapies is essential.

Purpose of the Study:

• To review oncologic and functional outcomes of primary focal treatments for localized prostate cancer.
• To synthesize evidence on new and established focal therapy techniques.
• To assess the impact of FT on patient quality of life.

Main Methods:

• Systematic literature search of Medline and Embase databases.
• Inclusion of studies on hemi-ablation, focal ablation, and target-ablation for primary PCa.
• Exclusion of salvage FT and studies with less than 12 months follow-up.

Main Results:

• 20 studies with 2523 patients were analyzed, using cryotherapy, HIFU, IRE, PDT, and FLA.
• Overall post-treatment positive biopsy rates ranged from 1.2-51%.
• Continence rates were high (90-100%), with erectile dysfunction rates varying from 0-53.2%.

Conclusions:

• Increasing evidence supports partial-gland treatment for PCa.
• Mid-term oncologic outcomes are encouraging with FT.
• Accurate patient selection and diligent follow-up are vital for optimal functional and oncologic results.