SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer
<b>Background/Objectives:</b> Focal therapy (FT) for prostate cancer (PCa) is an alternative to radical treatments that aims to balance cancer control and quality of life preservation in well-selected patients. Understanding its general principles and outcomes is key for its widespread a...
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2025-06-01
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| Series: | Société Internationale d’Urologie Journal |
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| author | Alessandro Marquis Jonathan Olivier Tavya G. R. Benjamin Eric Barret Giancarlo Marra Claire Deleuze Lucas Bento Kae J. Tay Hashim U. Ahmed Mark Emberton Arnauld Villers Thomas J. Polascik Ardeshir R. Rastinehad |
| author_facet | Alessandro Marquis Jonathan Olivier Tavya G. R. Benjamin Eric Barret Giancarlo Marra Claire Deleuze Lucas Bento Kae J. Tay Hashim U. Ahmed Mark Emberton Arnauld Villers Thomas J. Polascik Ardeshir R. Rastinehad |
| author_sort | Alessandro Marquis |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> Focal therapy (FT) for prostate cancer (PCa) is an alternative to radical treatments that aims to balance cancer control and quality of life preservation in well-selected patients. Understanding its general principles and outcomes is key for its widespread adoption and proper implementation. <b>Methods</b>: The International Consultation on Urological Diseases nominated a committee to review the literature on FT for PCa. A comprehensive PubMed search was conducted to identify articles focused on the different aspects of FT, including patient selection, imaging techniques, treatment modalities, cancer control and safety outcomes, integration with other approaches and future perspectives. <b>Results</b>: FT for PCa was introduced in the 1990s with cryotherapy and high-intensity focused ultrasound (HIFU) as pioneering modalities. Though initially guided by transrectal ultrasound (TRUS) and large biopsy templates, FT implementation expanded significantly with the advent of multiparametric magnetic resonance imaging (MRI) and the validation of the index lesion concept. Appropriate patient selection is key for FT and relies on prostate-specific antigen (PSA) metrics, MRI findings and targeted biopsy information. Multiple energy sources are now available, each with specific technical characteristics. Cancer control rates vary by energy modality, tumor characteristics, and institutional experience, demonstrating comparable outcomes to radical treatments in well-selected patients. The safety profile is excellent, with high rates of urinary continence and sexual function preservation. Post-treatment surveillance integrates PSA measurements, imaging, and histological assessment. Future directions for further FT adoption include the availability of long-term data, protocol standardization and technological improvements to enhance patient selection and treatment planning and delivery. <b>Conclusions</b>: FT is a valuable therapeutic option for selected patients with localized PCa, demonstrating promising oncological outcomes and better functional preservation compared to radical treatments. Understanding its principles and technical aspects is essential for offering comprehensive PCa care. |
| format | Article |
| id | doaj-art-0044543e98694027947bc0647979b331 |
| institution | Kabale University |
| issn | 2563-6499 |
| language | English |
| publishDate | 2025-06-01 |
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| record_format | Article |
| series | Société Internationale d’Urologie Journal |
| spelling | doaj-art-0044543e98694027947bc0647979b3312025-08-20T03:26:56ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992025-06-01634210.3390/siuj6030042SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate CancerAlessandro Marquis0Jonathan Olivier1Tavya G. R. Benjamin2Eric Barret3Giancarlo Marra4Claire Deleuze5Lucas Bento6Kae J. Tay7Hashim U. Ahmed8Mark Emberton9Arnauld Villers10Thomas J. Polascik11Ardeshir R. Rastinehad12Smith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell University, Lake Success, New York, NY 11042, USADepartment of Urology, Lille University Hospital, 59000 Lille, FranceSmith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell University, Lake Success, New York, NY 11042, USADepartment of Urology, Institut Mutualiste Montsouris, 75014 Paris, FranceUrology Clinic, Department of Surgical Sciences, City of Health and Sciences, Molinette University Hospital, University of Turin, 10126 Turin, ItalyDepartment of Urology, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UKDepartment of Urology, Institut Mutualiste Montsouris, 75014 Paris, FranceDepartment of Urology, Singapore General Hospital, Singapore 169854, SingaporeImperial Prostate, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London W6 8RF, UKDepartment of Urology, University College London Hospitals NHS Foundation Trust, London NW1 2BU, UKDepartment of Urology, Lille University Hospital, 59000 Lille, FranceDepartment of Urology, Duke Cancer Institute, Duke Medical Center, Durham, NC 27710, USASmith Institute for Urology, Zucker School of Medicine at Hofstra/Northwell University, Lake Success, New York, NY 11042, USA<b>Background/Objectives:</b> Focal therapy (FT) for prostate cancer (PCa) is an alternative to radical treatments that aims to balance cancer control and quality of life preservation in well-selected patients. Understanding its general principles and outcomes is key for its widespread adoption and proper implementation. <b>Methods</b>: The International Consultation on Urological Diseases nominated a committee to review the literature on FT for PCa. A comprehensive PubMed search was conducted to identify articles focused on the different aspects of FT, including patient selection, imaging techniques, treatment modalities, cancer control and safety outcomes, integration with other approaches and future perspectives. <b>Results</b>: FT for PCa was introduced in the 1990s with cryotherapy and high-intensity focused ultrasound (HIFU) as pioneering modalities. Though initially guided by transrectal ultrasound (TRUS) and large biopsy templates, FT implementation expanded significantly with the advent of multiparametric magnetic resonance imaging (MRI) and the validation of the index lesion concept. Appropriate patient selection is key for FT and relies on prostate-specific antigen (PSA) metrics, MRI findings and targeted biopsy information. Multiple energy sources are now available, each with specific technical characteristics. Cancer control rates vary by energy modality, tumor characteristics, and institutional experience, demonstrating comparable outcomes to radical treatments in well-selected patients. The safety profile is excellent, with high rates of urinary continence and sexual function preservation. Post-treatment surveillance integrates PSA measurements, imaging, and histological assessment. Future directions for further FT adoption include the availability of long-term data, protocol standardization and technological improvements to enhance patient selection and treatment planning and delivery. <b>Conclusions</b>: FT is a valuable therapeutic option for selected patients with localized PCa, demonstrating promising oncological outcomes and better functional preservation compared to radical treatments. Understanding its principles and technical aspects is essential for offering comprehensive PCa care.https://www.mdpi.com/2563-6499/6/3/42focal therapyfocal ablationprostate cancer |
| spellingShingle | Alessandro Marquis Jonathan Olivier Tavya G. R. Benjamin Eric Barret Giancarlo Marra Claire Deleuze Lucas Bento Kae J. Tay Hashim U. Ahmed Mark Emberton Arnauld Villers Thomas J. Polascik Ardeshir R. Rastinehad SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer Société Internationale d’Urologie Journal focal therapy focal ablation prostate cancer |
| title | SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer |
| title_full | SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer |
| title_fullStr | SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer |
| title_full_unstemmed | SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer |
| title_short | SIU-ICUD: Principles and Outcomes of Focal Therapy in Localized Prostate Cancer |
| title_sort | siu icud principles and outcomes of focal therapy in localized prostate cancer |
| topic | focal therapy focal ablation prostate cancer |
| url | https://www.mdpi.com/2563-6499/6/3/42 |
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