Focal Therapy for Localized Prostate Cancer: A Case Series with Cost Analysis

Area of Science:

• Urology
• Oncology
• Minimally Invasive Surgery

Background:

• Prostate cancer (PCa) management traditionally involves whole-gland treatments like surgery or radiation.
• Focal therapy presents a less invasive alternative for localized PCa.
• Limited data exists on the comparative functional outcomes and cost-effectiveness of different focal therapies.

Purpose of the Study:

• To present a case series of high-intensity focused ultrasound (HIFU), cryoablation, and irreversible electroporation (IRE) for PCa.
• To conduct a cost analysis of these focal therapies.
• To review the literature on focal PCa treatment outcomes.

Main Methods:

• Retrospective review of 45 patients undergoing focal HIFU, cryoablation, or IRE for localized PCa.
• Exclusion of patients who received whole-gland therapy.
• Collection of functional outcome data (erectile dysfunction, urinary symptoms) and cost data.

Main Results:

• No significant difference in pre- and post-focal therapy PSA levels observed.
• Three patients experienced biochemical recurrence requiring biopsy.
• Mean cost was $3804.50, with no significant cost difference between treatment modalities.
• No metastatic events or deaths occurred at a median 6-month follow-up.
• Functional outcomes remained largely unaltered.

Conclusions:

• Focal therapies (HIFU, cryoablation, IRE) provide adequate short-term cancer control for localized PCa.
• These treatments demonstrate comparable costs and minimal impact on functional outcomes.
• Further research with longer follow-up is needed to fully assess long-term efficacy and oncologic control.