Abstract
Focal therapy (FT) represents a potential shift in clinical practice by featuring a tissue-sparing approach for prostate cancer (PCa) treatment. It stands midway between active surveillance (AS) and more aggressive options like radical prostatectomy (RP) or radiotherapy. The field has enormously evolved in the last few years but there are still pending questions to answer in the future. The manuscript overlooks FT in terms of indications, available energies, situation of tumor microenvironment, follow-up, re-interventions, and the future of this approach for PCa.
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Onik G, Narayan P, Vaughan D, Dineen M, Brunelle R. Focal “nerve-sparing” cryosurgery for treatment of primary prostate cancer: a new approach to preserving potency. Urology. 2002;60(1):109–14.
Onik G, Vaughan D, Lotenfoe R, Dineen M, Brady J. The “male lumpectomy”: focal therapy for prostate cancer using cryoablation results in 48 patients with at least 2-year follow-up. Urol Oncol. 2008;26(5):500–5.
de la Rosette J, Ahmed H, Barentsz J, Johansen TB, Brausi M, Emberton M, et al. Focal therapy in prostate cancer-report from a consensus panel. J Endourol. 2010;24(5):775–80.
Donaldson IA, Alonzi R, Barratt D, Barret E, Berge V, Bott S, et al. Focal therapy: patients, interventions, and outcomes—a report from a consensus meeting. Eur Urol. 2015;67(4):771–7.
Muller BG, van den Bos W, Pinto PA, de la Rosette JJ. Imaging modalities in focal therapy: patient selection, treatment guidance, and follow-up. Curr Opin Urol. 2014;24(3):218–24.
Linares Espinós E, Barret E, Sivaraman A, Pérez-Reggeti JI, Sánchez-Salas R, Rozet F, Galiano M, Cathelineau X. Localized prostate cancer Focal Therapy: “A la carte” Model. Arch Esp Urol. 2016
Lindner U, Weersink RA, Haider MA, Gertner MR, Davidson SR, Atri M, et al. Image guided photothermal focal therapy for localized prostate cancer: phase I trial. J Urol. 2009;182(4):13717.
Gladwell, Malcolm. The tipping point – How little things can make a difference. Ed. Little, Brown and Company (2000). Print.
Walz J et al. Committee1 Diagnosis of Prostate Cancer and Selection for Focal Therapy. In: Image-Guided Therapies for Prostate and Kidney Cancers. A Joint SIU-ICUD International Consultation. Sanchez-Salas, R and Desai, M. [eds.] Melbourne, Australia. October 15–18. Available at: http://www.siu-urology.org/society/siu-icud. Forthcoming October 2016.
van der Poel H, Klotz L, Andriole G, Azzouzi AR, Bjartell A, Cussenot O, et al. Role of active surveillance and focal therapy in low- and intermediate-risk prostate cancers. World J Urol. 2015;33(7):907–16. doi:10.1007/s00345-015-1603-7.Epub2015Jun.
Ahmed HU, Dickinson L, Charman S, Weir S, McCartan N, Hindley RG, et al. Focal ablation targeted to the index lesion in multifocal localised prostate cancer: a prospective development study. Eur Urol. 2015;68(6):927–36. doi:10.1016/j.eururo.2015.01.030.
Postema AW, De Reijke TM, Ukimura O, Van den Bos W, Azzouzi AR, Barret E, Baumunk D, Blana A, Bossi A, Brausi M, Coleman JA, Crouzet S, Dominguez-Escrig J, Eggener S, Ganzer R, Ghai S, Gill IS, Gupta RT, Henkel TO, Hohenfellner M, Jones JS, Kahmann F, Kastner C, Köhrmann KU, Kovacs G, Miano R, van Moorselaar RJ, Mottet N, Osorio L, Pieters BR, Polascik TJ, Rastinehad AR, Salomon G, Sanchez-Salas R, Schostak M, Sentker L, Tay KJ, Varkarakis IM, Villers A, Walz J, De la Rosette JJ. Standardization of definitions in focal therapy of prostate cancer: report from a Delphi consensus project. World J Urol. 2016 Feb 18.
Muller BG, van den Bos W, Brausi M, Fütterer JJ, Ghai S, Pinto PA, et al. Follow-up modalities in focal therapy for prostate cancer: results from a Delphi consensus project. World J Urol. 2015;33(10):1503–9. doi:10.1007/s00345-014-1475-2.
van den Bos W, Muller BG, Ahmed H, Bangma CH, Barret E, Crouzet S, et al. Focal therapy in prostate cancer: international multidisciplinary consensus on trial design. Eur Urol. 2014;65(6):1078–83. doi:10.1016/j.eururo.2014.01.001.
Muller BG, Fütterer JJ, Gupta RT, Katz A, Kirkham A, Kurhanewicz J, et al. The role of magnetic resonance imaging (MRI) in focal therapy for prostate cancer: recommendations from a consensus panel. BJU Int. 2014;113(2):218–27. doi:10.1111/bju.12243.
Ho R, Siddiqui MM, George AK, Frye T, Kilchevsky A, Fascelli M, et al. Preoperative multiparametric magnetic resonance imaging predicts biochemical recurrence in prostate cancer after radical prostatectomy. PLoS One. 2016;11(6):e0157313. doi:10.1371/journal.pone.0157313.eCollection 2016.
Barret et al. Committee 3 Imaging in localized Prostate Cancer. Multiparametric Magnetic Resonance Imaging. In: Image-Guided Therapy for Prostate and Kidney Cancers. A Joint SIU-ICUD International Consultation. Sanchez-Salas, R and Desai, M. [eds.] Melbourne, Australia. October 15–18, 2015. Available at: http://www.siu-urology.org/society/siu-icud. Forthcoming October 2016.
Moore CM, Robertson NL, Arsanious N, Middleton T, Villers A, Klotz L, et al. Image-guided prostate biopsy using magnetic resonance imaging-derived targets: a systematic review. Eur Urol. 2013;63(1):125–40.
Siddiqui MM, George AK, Rubin R, Rais-Bahrami S, Parnes HL, Merino MJ, Simon RM, Turkbey B, Choyke PL, Wood BJ, Pinto PA. Efficiency of Prostate Cancer Diagnosis by MR/Ultrasound Fusion-Guided Biopsy vs Standard Extended-Sextant Biopsy for MR-Visible Lesions. J Natl Cancer Inst. 2016 Apr 29;108(9). pii: djw039. doi:10.1093/jnci/djw039. Print 2016 Sep.
Konety et al. Committee 3 Prostatic biopsies: available techniques and approaches. In: Image-Guided Therapy for Prostate and Kidney Cancers. A Joint SIU-ICUD International Consultation. Sanchez-Salas, R and Desai, M. [eds.] Melbourne, Australia. October 15–18, 2015. Available at: http://www.siu-urology.org/society/siu-icud. Forthcoming October 2016.
Barret E, Ahallal Y, Sanchez-Salas R, Galiano M, Cosset JM, Validire P, et al. Morbidity of focal therapy in the treatment of localized prostate cancer. Eur Urol. 2013;63(4):618–22. doi:10.1016/j.eururo.2012.11.057.
Perez-Reggeti JI, Sanchez-Salas R, Sivaraman A, Linares Espinos E, de Gracia-Nieto AE, Barret E, Galiano M, Rozet F, Fregeville A, Renard-Penna R, Cathala N, Mombet A, Prapotnich D, Cathelineau X. High intensity focused ultrasound with Focal-One® device: Prostate-specific antigen impact and morbidity evaluation during the initial experience. Actas Urol Esp. 2016 Aug 16.
Durand M, Barret E, Galiano M, Rozet F, Sanchez-Salas R, Ahallal Y, Macek P, Gaya JM, Cerruti J, Devilliers H, Loeffler J, Amiel J, Vallancien G, Cathelineau X. Focal cryoablation: a treatment option for unilateral low-risk prostate cancer.
Cosset JM, Cathelineau X, Wakil G, Pierrat N, Quenzer O, Prapotnich D, et al. Focal brachytherapy for selected low-risk prostate cancers: a pilot study. Brachytherapy. 2013;12(4):331–7.
De la Rosette T et al. Committee 4 Available Ablation Energies to Treat Prostate Cancer. In: Image-Guided Therapy for Prostate and Kidney Cancers. A Joint SIU-ICUD International Consultation. Sanchez-Salas, R and Desai, M. [eds.] Melbourne, Australia. October 15–18, 2015. Available at: http://www.siu-urology.org/society/siu-icud. Forthcoming October 2016.
Sivaraman A, Barret E. Focal therapy for prostate cancer: an “À la Carte” approach. Eur Urol. 2016;69(6):973–5.
Stern JM, Kibanov Solomonov VV, Sazykina E, Schwartz JA, Gad SC, Goodrich GP. Initial evaluation of the safety of nanoshell-directed photothermal therapy in the treatment of prostate disease. Int J Toxicol. 2016;35(1):38–46. doi:10.1177/1091581815600170.
Preise D, Scherz A, Salomon Y. Antitumor immunity promoted by vascular occluding therapy: lessons from vascular-targeted photodynamic therapy (VTP). Photochem Photobiol Sci. 2011;10(5):681–8. doi:10.1039/c0pp00315h.
Azzouzi AR, Barret E, Bennet J, Moore C, Taneja S, Muir G, et al. TOOKAD® soluble focal therapy: pooled analysis of three phase II studies assessing the minimally invasive ablation of localized prostate cancer. World J Urol. 2015;33(7):945–53.
Hu J, Xu H, Zhu W, et al. Neo-adjuvant hormone therapy for non-metastatic prostate cancer: a systematic review and meta-analysis of 5194 patients. World J Surg Oncol. 2015;13:73.
Cussenot O, Cornu JN, Drouin SJ, Mozer P, Egrot C, Vaessen C, et al. Secondary chemoprevention of localized prostate cancer by short-term androgen deprivation to select indolent tumors suitable for active surveillance: a prospective pilot phase II study. World J Urol. 2014;32(2):545–50. doi:10.1007/s00345-013-1196-y.
Barret E, Harvey-Bryan KA, Sanchez-Salas R, Rozet F, Galiano M, Cathelineau X. How to diagnose and treat focal therapy failure and recurrence? Curr Opin Urol. 2014;24(3):241–6.
Valerio M, Ahmed HU, Emberton M, Lawrentschuk N, Lazzeri M, Montironi R, et al. The role of focal therapy in the management of localised prostate cancer: a systematic review. Eur Urol. 2014;66(4):732–51.
Polascik T et al. Committee 5 Surveillance after Focal Therapy. In: Image-Guided Therapy for Prostate and Kidney Cancers. A Joint SIU-ICUD International Consultation. Sanchez-Salas, R and Desai, M. [eds.] Melbourne, Australia. October 15–18, 2015. Available at: http://www.siu-urology.org/society/siu-icud. Forthcoming October 2016.
Linares Espinós E, Sánchez-Salas R, Sivaraman A, Perez-Reggeti JI, Barret E, Rozet F, et al. Minimally invasive salvage prostatectomy after primary radiation or ablation treatment. Urology. 2016;94:111–6.
Duijzentkunst DA, Peters M, van der Voort van Zyp JR, Moerland MA, van Vulpen M .Focal salvage therapy for local prostate cancer recurrences after primary radiotherapy: a comprehensive review. World J Urol. 2016 Mar 24. [Epub ahead of print].
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Xavier Cathelineau and Rafael Sanchez-Salas each declare no potential conflicts of interest.
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Cathelineau, X., Sanchez-Salas, R. Focal Therapy for Prostate Cancer: Pending Questions. Curr Urol Rep 17, 86 (2016). https://doi.org/10.1007/s11934-016-0644-9
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DOI: https://doi.org/10.1007/s11934-016-0644-9