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Focal Laser Ablation of Prostate Cancer: An Office Procedure
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German S3 Evidence-Based Guidelines on Focal Therapy in Localized Prostate Cancer: The First Evidence-Based

Angelika Borkowetz1,2,3, Andreas Blana1,2,4, Dirk Böhmer5,6

  • 1German Society of Urology (DGU), Berlin, Germany.

Urologia Internationalis
|February 10, 2022
PubMed
Summary

Focal therapy (FT) offers a way to treat localized prostate cancer (PCa) while preserving tissue. The German S3 guidelines now provide evidence-based recommendations for FT, covering diagnosis, indications, and follow-up.

Keywords:
CryotherapyEvidenceFocal therapyGuidelinesHigh-intensity focused ultrasound ablationIrreversible electroporationProstate cancerVascular targeted photodynamic therapy

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Area of Science:

  • Urology
  • Oncology
  • Medical Guidelines

Background:

  • Focal therapy (FT) is an option for localized prostate cancer (PCa) aiming to reduce side effects of whole-gland treatment.
  • Current guidelines are cautious on FT due to limited prospective trial data, with no international guidelines featuring a dedicated FT section.
  • This work provides a synopsis of the German S3 guidelines on FT for potential international application.

Purpose of the Study:

  • To present a synopsis of the consensus-based German S3 guidelines concerning focal therapy for localized prostate cancer.
  • To offer recommendations for diagnostic work-up, indications, modalities, and follow-up for FT in PCa treatment.

Main Methods:

  • The study is based on the recently updated German S3 guidelines for prostate cancer.
  • These guidelines are evidence- and consensus-based, incorporating expert consensus.
  • The guidelines include 12 statements and recommendations specifically for FT in localized PCa.

Main Results:

  • The German S3 guidelines now include a dedicated section on focal therapy for localized prostate cancer.
  • Recommendations cover diagnostic work-up, patient selection criteria, treatment modalities, and post-treatment follow-up.
  • This represents the first guideline to incorporate FT recommendations based on evidence and expert consensus.

Conclusions:

  • The updated German S3 guidelines provide comprehensive recommendations for focal therapy in localized prostate cancer.
  • These guidelines offer a structured approach to FT, including diagnostic pathways and technique overview.
  • This resource aims to support the international application of evidence-based FT for PCa.