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Parameters Predicting Recurrence after Focal Therapy for Prostate Cancer: Insights from a Multicenter Surveillance

Martin Schostak1,2, Emma Peklo3, Inga Peters4,5

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Summary
This summary is machine-generated.

Focal therapy for prostate cancer recurrence is common, with nearly 40% of patients experiencing it within two years. Follow-up MRI scans are key predictors of treatment failure, guiding future prostate cancer management.

Keywords:
Focal therapyMulticenter studyPredictors of recurrenceProstate cancer

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Area of Science:

  • Urology
  • Oncology
  • Medical Imaging

Background:

  • Focal therapy (FT) offers a minimally invasive approach for localized prostate cancer (PCa).
  • Long-term efficacy data and recurrence predictors for FT are limited.
  • Current research aims to define predictors of oncological failure after FT.

Purpose of the Study:

  • To evaluate recurrence-free survival (RFS) and progression-free survival (PFS) after FT for localized PCa.
  • To identify independent predictors of oncological outcomes following FT.
  • To assess the role of multiparametric MRI (mpMRI) in predicting recurrence after FT.

Main Methods:

  • Retrospective multicenter cohort study of 209 men with unifocal or oligo-focal PCa treated with FT (HIFU, VTP, cryotherapy, TULSA).
  • Prospective collection of clinical, histopathological, treatment, and mpMRI data.
  • Kaplan-Meier analysis for RFS and PFS; Cox regression for predictor identification.

Main Results:

  • Median follow-up was 1.73 years; 40% experienced recurrence, 15% showed progression.
  • RFS varied significantly by treatment modality (p=0.001).
  • Suspicious follow-up mpMRI was the sole independent predictor of recurrence (HR 2.07, p=0.005).

Conclusions:

  • Recurrence after FT for prostate cancer is frequent, occurring in 40% of patients within two years.
  • mpMRI findings, particularly post-treatment, are strong predictors of oncological failure.
  • Standardized imaging is crucial for patient selection and surveillance in FT protocols.