The prostate cancer focal therapy

Area of Science:

• Oncology
• Urology
• Medical Imaging

Background:

• Prostate cancer (PCa) is a leading non-cutaneous cancer in men, with many patients dying with the disease, not from it.
• Overtreatment is a concern, necessitating differentiation between high-risk PCa requiring radical treatment and candidates for conservative management like active surveillance or focal therapy (FT).

Purpose of the Study:

• To review the rationale and current evidence for focal therapy (FT) in prostate cancer (PCa) management.
• To discuss patient eligibility, optimal imaging for lesion localization, current FT techniques, oncological outcomes, and future research directions.

Main Methods:

• Literature review focusing on advances in PCa understanding and imaging.
• Analysis of evidence supporting FT, including multiparametric magnetic resonance imaging (mpMRI) for detection and risk stratification.
• Summary of current FT modalities and their outcomes.

Main Results:

• FT aims to eradicate significant PCa while preserving genito-urinary structures and function.
• Advances in understanding the index lesion and mpMRI improve PCa detection and risk stratification, supporting FT.
• Evidence on FT effectiveness compared to conventional options is still developing.

Conclusions:

• Focal therapy (FT) presents a promising organ-sparing approach for select prostate cancer (PCa) patients.
• Improved imaging and understanding of PCa biology are key drivers for the development of FT.
• Further research and comparative effectiveness studies are needed to establish FT's role in PCa management.