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The Challenges of Patient Selection for Prostate Cancer Focal Therapy: A Retrospective Observational Multicentre
Alessio Paladini1, Giovanni Cochetti1, Alexandre Colau2
1Urology Clinic, Department of Medicine and Surgery, University of Perugia, 06129 Perugia, Italy.
Current Oncology (Toronto, Ont.)
|October 27, 2022
Summary
Focal therapy (FT) for prostate cancer (PCa) shows promise but requires careful patient selection. Higher PSA levels may predict FT failure, highlighting the need for precise criteria in treating low-risk PCa.
Area of Science:
- Urology
- Oncology
- Medical Technology
Background:
- Increased diagnoses of prostate cancer (PCa) lead to overtreatment and side effects.
- Focal therapy (FT) targets only the main tumor lesion, aiming to reduce morbidity.
- Accurate patient selection is crucial for the success of FT.
Purpose of the Study:
- To analyze predictive factors for focal therapy failure in prostate cancer.
- To evaluate the oncological safety of FT based on specific criteria.
- To identify patient subgroups who may benefit from FT.
Main Methods:
- Retrospective analysis of 67 patients undergoing robot-assisted radical prostatectomy (RARP).
- Inclusion criteria: MRI-detected lesion, Gleason Score ≤7, ≤cT2a, PSA ≤10 ng/mL, and specific biopsy results.
- Uni- and multivariate logistic regression used to predict FT failure.
Main Results:
- Potential FT failure occurred in 32 patients.
- Only PSA value was identified as a significant predictive parameter for FT failure (p < 0.05).
- Challenges in FT include patient selection due to multifocal disease.
Conclusions:
- Focal therapy may be a viable option for carefully selected low-risk prostate cancer patients.
- PSA levels are a key factor in predicting FT outcomes.
- Improved patient selection criteria are essential for optimizing FT efficacy.
