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Focal therapy for prostate cancer 1996: maximizing outcome
P R Carroll1, J C Presti, E Small
1Department of Urology, University of California School of Medicine, San Francisco, USA.
Urology
|March 1, 1997
Summary
Accurate patient selection and advanced techniques improve localized prostate cancer management. Treatments like surgery, radiation, and cryotherapy offer effective options for curable prostate cancer.
Area of Science:
- Oncology
- Urology
Background:
- Localized prostate cancer management requires precise patient selection.
- Focal therapy represents an evolving treatment modality.
Purpose of the Study:
- To review advancements in patient selection for localized prostate cancer.
- To summarize the outcomes of focal therapy in managing localized prostate cancer.
Main Methods:
- Review of contemporary patient series treated with surgical excision, radiation therapy (3D-CRT, interstitial, proton therapy), and cryotherapy.
- Utilized preoperative cancer grade, transrectal ultrasound, and PSA for staging.
- Incorporated cross-sectional imaging and bone scans for select patients.
Main Results:
- Accurate staging enabled selection of patients for radical prostatectomy or radiation.
- Wide surgical excision with clear margins demonstrated therapeutic value in extracapsular extension.
- Newer radiation techniques improved cancer control rates.
- Cryotherapy showed a 48% undetectable PSA rate and 23% positive biopsy rate for T1-T3 prostate cancer.
Conclusions:
- Organ-confined prostate cancer is identifiable and curable.
- Radical prostatectomy, radiation, and cryotherapy are viable alternative treatments for localized prostate cancer.