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Surveillance after prostate focal therapy.

Kae Jack Tay1,2, Mahul B Amin3, Sangeet Ghai4

  • 1Division of Urology, Duke University, Durham, NC, USA. tay.kae.jack@singhealth.com.sg.

World Journal of Urology
|June 28, 2018
PubMed
Summary

Surveillance after prostate focal therapy requires regular multiparametric MRI and biopsies. Current guidelines balance evidence and expert opinion for optimal oncological outcomes.

Keywords:
BrachytherapyCryotherapyFocal therapyFusion biopsyHIFUIrreversible electroporationLaser ablationProstate cancerProstatectomyRadiation therapySurveillanceVTPmpMRI

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Area of Science:

  • Urology
  • Oncology
  • Medical Imaging

Background:

  • Long-term outcome data for prostate focal therapy cohorts are limited.
  • Existing surveillance protocols lack robust evidence.
  • This review updates 2015 guidelines based on current evidence and expert consensus.

Purpose of the Study:

  • To establish evidence-based surveillance guidelines after prostate focal therapy.
  • To synthesize current evidence and expert opinion for post-treatment follow-up.
  • To address the need for standardized protocols in a developing field.

Main Methods:

  • Systematic literature search of PubMed, Cochrane, and Embase databases.
  • Inclusion of studies on primary prostate focal therapy for prostate cancer.
  • Synthesis of findings to form consensus recommendations.

Main Results:

  • Recommended surveillance includes multiparametric MRI at 3-6 months, 12-24 months, and 5 years.
  • Biopsy protocols involve targeted biopsy at 3-6 months, fusion biopsy for suspicious lesions, and systematic biopsy at 12-24 months and 5 years.
  • Acceptable findings include small volumes of low-grade cancer (PGG 1-2) in the treated zone; higher grades or new significant cancers require further treatment.

Conclusions:

  • Focal therapy for prostate cancer is an evolving area with limited long-term data.
  • Current surveillance recommendations are based on the best available evidence and expert consensus.
  • Further research is needed to optimize oncologically safe and cost-effective follow-up strategies.