Perhaps with further improvements of imaging modalities and improved targeting of ablation zones, the efficacy of focal treatments will improve. For example, in recent years, novel PET agents that more effectively detect prostate cancer have reached the US commercial market. Platforms such as PSMA PET in combination with MRI fusion provide improved cancer detection, localization, and characterization [55,56]. Additionally, contrast enhanced and superhigh-frequency ultrasound have shown some promise for improved cancer detection [57,58]. It has yet to be seen how integration of these new technologies will affect focal therapy outcomes, but optimism abounds about our future ability to treat well-selected patients with localized prostate cancer with less invasive approaches and less morbidity.
Papers of particular interest, published within the annual period of review, have been highlighted as:
2. Pinsky PF, Parnes HL, Andriole G. Mortality and complications after prostate biopsy in the Prostate, Lung, Colorectal and Ovarian Cancer Screening (PLCO) trial. BJU Int 2014; 113:254–259.
3. Ficarra V, Novara G, Rosen RC, et al. Systematic review and meta-analysis of studies reporting urinary continence recovery after robot-assisted radical prostatectomy. Eur Urol 2012; 62:405–417.
4. Ficarra V, Sooriakumaran P, Novara G, et al. Systematic review of methods for reporting combined outcomes after radical prostatectomy and proposal of a novel system: the survival, continence, and potency (SCP) classification. Eur Urol 2012; 61:541–548.
5. Kearns JT, Holt SK, Wright JL, et al. PSA screening, prostate biopsy, and treatment of prostate cancer
in the years surrounding the USPSTF recommendation against prostate cancer
screening. Cancer 2018; 124:2733–2739.
6. Walsh PC. Radical retropubic prostatectomy with reduced morbidity: an anatomic approach. NCI Monogr 1988; 133–137.
7. Novara G, Ficarra V, Rosen RC, et al. Systematic review and meta-analysis of perioperative outcomes and complications after robot-assisted radical prostatectomy. Eur Urol 2012; 62:431–452.
8. Novara G, Ficarra V, Mocellin S, et al. Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. Eur Urol 2012; 62:382–404.
9. Novara G, Ficarra V. Reply to Stefano C.M. Picozzi, Cristian Ricci and Luca Carmignani's letter to the editor re: Giacomo Novara, Vincenzo Ficarra, Simone Mocellin, et al.
Systematic review and meta-analysis of studies reporting oncologic outcome after robot-assisted radical prostatectomy. Eur Urol 62:382–404. Eur Urol. 2013;63(2):e29-31.
10. Zaorsky NG, Shaikh T, Murphy CT, et al. Comparison of outcomes and toxicities among radiation therapy treatment options for prostate cancer
. Cancer Treat Rev 2016; 48:50–60.
11. Schauer I, Keller E, Muller A, Madersbacher S. Have rates of erectile dysfunction improved within the past 17 years after radical prostatectomy? A systematic analysis of the control arms of prospective randomized trials on penile rehabilitation. Andrology 2015; 3:661–665.
12. Ficarra V, Novara G, Ahlering TE, et al. Systematic review and meta-analysis of studies reporting potency rates after robot-assisted radical prostatectomy. Eur Urol 2012; 62:418–430.
13. Wallis CJ, Glaser A, Hu JC, et al. Survival and complications following surgery and radiation for localized prostate cancer
: an international collaborative review. Eur Urol 2018; 73:11–20.
14. Onik G, Narayan P, Vaughan D, et al. Focal ‘nerve-sparing’ cryosurgery for treatment of primary prostate cancer
: a new approach to preserving potency. Urology 2002; 60:109–114.
15. Kurhanewicz J, Vigneron D, Carroll P, Coakley F. Multiparametric magnetic resonance imaging in prostate cancer
: present and future. Curr Opin Urol 2008; 18:71–77.
16. De Visschere PJ, Briganti A, Futterer JJ, et al. Role of multiparametric magnetic resonance imaging in early detection of prostate cancer
. Insights Imaging 2016; 7:205–214.
17. Futterer JJ, Briganti A, De Visschere P, et al. Can clinically significant prostate cancer
be detected with multiparametric magnetic resonance imaging? A systematic review of the literature. Eur Urol 2015; 68:1045–1053.
18. Borofsky S, George AK, Gaur S, et al. What are we missing? False-negative cancers at multiparametric MR imaging of the prostate. Radiology 2018; 286:186–195.
19. De Visschere PJ, Naesens L, Libbrecht L, et al. What kind of prostate cancers do we miss on multiparametric magnetic resonance imaging? Eur Radiol 2016; 26:1098–1107.
20. Kamrava M, Chung M, Mesko S, et al. Correlation of quantitative diffusion-weighted and dynamic contrast-enhanced MRI parameters with NCCN risk group, Gleason score, and maximum tumor diameter in prostate cancer
. Pract Radiat Oncol 2013; 3 (2 Suppl 1):S4.
21. Le JD, Tan N, Shkolyar E, et al. Multifocality and prostate cancer
detection by multiparametric magnetic resonance imaging: correlation with whole-mount histopathology. Eur Urol 2015; 67:569–576.
22. Nassiri N, Chang E, Lieu P, et al. Focal therapy
eligibility determined by magnetic resonance imaging/ultrasound fusion biopsy. J Urol 2018; 199:453–458.
23. Lindner U, Trachtenberg J, Lawrentschuk N. Focal therapy
in prostate cancer
: modalities, findings and future considerations. Nat Rev Urol 2010; 7:562–571.
24. Barkin J. High intensity focused ultrasound (HIFU). Can J Urol 2011; 18:5634–5643.
25▪▪. Guillaumier S, Peters M, Arya M, et al. A Multicentre study of 5-year Outcomes following focal therapy
in treating clinically significant nonmetastatic prostate cancer
. Eur Urol 2018; 74:422–421.
Prospective cohort trial reporting the results of HIFU for the treatment of Gleason 6–8 cancers for 625 patients. This study reports low cancer recurrence rates, however, posttreatment biopsies were not performed in all patients.
26▪. Ahmed HU, Dickinson L, Charman S, et al. Focal ablation targeted to the index lesion in multifocal localised prostate cancer
: a prospective development study. Eur Urol 2015; 68:927–936.
Prospective cohort trial reporting the results of HIFU for the treatment of Gleason 6–7 cancers for 56 patients.
27. Ghai S, Perlis N, Lindner U, et al. Magnetic resonance guided focused high frequency ultrasound ablation for focal therapy
in prostate cancer
: phase 1 trial. Eur Radiol 2018; 28:4281–4287.
28. von Hardenberg J, Westhoff N, Baumunk D, et al. Prostate cancer
treatment by the latest focal HIFU device with MRI/TRUS-fusion control biopsies: A prospective evaluation. Urol Oncol 2018; 36:401.e1–401.e9.
29. van der Poel HG, van den Bergh RC, Briers E, et al. Focal therapy
in primary localised prostate cancer
: The European Association of Urology position in 2018. Eur Urol 2018; 74:84–91.
30. Uchida T, Tomonaga T, Kim H, et al. Improved outcomes with advancements in high intensity focused ultrasound devices for the treatment of localized prostate cancer
. J Urol 2015; 193:103–110.
31. Colin P, Mordon S, Nevoux P, et al. Focal laser ablation
of prostate cancer
: definition, needs, and future. Adv Urol 2012; 2012:589160.
32. Stafford RJ, Shetty A, Elliott AM, et al. Magnetic resonance guided, focal laser induced interstitial thermal therapy in a canine prostate model. J Urol 2010; 184:1514–1520.
33. Cordeiro ER, Cathelineau X, Thuroff S, et al. High-intensity focused ultrasound
(HIFU) for definitive treatment of prostate cancer
. BJU Int 2012; 110:1228–1242.
34. Natarajan S, Jones TA, Priester AM, et al. Focal laser ablation
of prostate cancer
: feasibility of magnetic resonance imaging-ultrasound fusion for guidance. J Urol 2017; 198:839–847.
35. Eggener SE, Yousuf A, Watson S, et al. Phase II evaluation of magnetic resonance imaging guided focal laser ablation
of prostate cancer
. J Urol 2016; 196:1670–1675.
36. Oto A, Sethi I, Karczmar G, et al. MR Imaging-guided focal laser ablation
for prostate cancer
: phase I trial. Radiology 2013; 267:932–940.
37. Natarajan S, Raman S, Priester AM, et al. Focal laser ablation
of prostate cancer
: phase I clinical trial. J Urol 2016; 196:68–75.
38. Lindner U, Weersink RA, Haider MA, et al. Image guided photothermal focal therapy
for localized prostate cancer
: phase I trial. J Urol 2009; 182:1371–1377.
39. Lindner U, Lawrentschuk N, Trachtenberg J. Focal laser ablation
for localized prostate cancer
. J Endourol 2010; 24:791–797.
40. Feller J, Greenwood B, Jones W, Toth R. Mp30-02 transrectally delivered, outpatient MRI-guided laser focal therapy
of prostate cancer
: seven year interim results of NCT #02243033. The Journal of Urology 2018; 199:e374–e375.
41. Bloom JB, Gold SA, Hale GR, et al. Super-active surveillance’: MRI ultrasound fusion biopsy and ablation for less invasive management of prostate cancer
. Gland Surg 2018; 7:166–187.
42. Gage AA, Baust J. Mechanisms of tissue injury in cryosurgery. Cryobiology 1998; 37:171–186.
43. Mendez MH, Passoni NM, Pow-Sang J, et al. Comparison of outcomes between preoperatively potent men treated with focal versus whole gland cryotherapy in a matched population. J Endourol 2015; 29:1193–1198.
44. Valerio M, Shah TT, Shah P, et al. Magnetic resonance imaging-transrectal ultrasound fusion focal cryotherapy of the prostate: A prospective development study. Urol Oncol 2017; 35:150.e1–150.e7.
45. Tay KJ, Polascik TJ, Elshafei A, et al. Propensity score-matched comparison of partial to whole-gland cryotherapy for intermediate-risk prostate cancer
: an analysis of the cryo on-line data registry data. J Endourol 2017; 31:564–571.
46. Werneburg GT, Kongnyuy M, Halpern DM, et al. Effects of focal vs total cryotherapy and minimum tumor temperature on patient-reported quality of life compared with active surveillance in patients with prostate cancer
. Urology 2018; 113:110–118.
47. Davalos RV, Mir IL, Rubinsky B. Tissue ablation with irreversible electroporation. Ann Biomed Eng 2005; 33:223–231.
48▪. van den Bos W, Scheltema MJ, Siriwardana AR, et al. Focal irreversible electroporation as primary treatment for localized prostate cancer
. BJU Int 2018; 121:716–724.
Prospective cohort trial reporting the results of IRE for the treatment of Gleason 6-8 cancers for 63 patients.
49▪▪. Gill IS, Azzouzi AR, Emberton M, et al. Randomized trial of partial gland ablation with vascular targeted phototherapy versus active surveillance for low risk prostate cancer
: extended followup and analyses of effectiveness. J Urol 2018; 200:786–793.
Prospective randomized controlled trial reporting the results of PDT for the treatment of Gleason 6 cancers as an alternative to active surveillance to prevent the need for radical therapy. This study is a follow-up to the results of Azzouzi et al. 2017.
50▪▪. Azzouzi AR, Vincendeau S, Barret E, et al. Padeliporfin vascular-targeted photodynamic therapy
versus active surveillance in men with low-risk prostate cancer
(CLIN1001 PCM301): an open-label, phase 3, randomised controlled trial. Lancet Oncol 2017; 18:181–191.
Prospective randomized controlled trial reporting the results of PDT for the treatment of Gleason 6 cancers as an alternative to active surveillance to prevent the need for radical therapy. In total, 50% of patients had no detectable cancer following treatment.
51. Kimm SY, Tarin TV, Monette S, et al. Nonthermal ablation by using intravascular oxygen radical generation with WST11: dynamic tissue effects and implications for focal therapy
. Radiology 2016; 281:109–118.
52. Ritch CR, Punnen S. Photodynamic therapy
for low risk prostate cancer
. BMJ 2017; 356:j575.
53. Chen Y, Chatterjee S, Lisok A, et al. A PSMA-targeted theranostic agent for photodynamic therapy
. J Photochem Photobiol B 2017; 167:111–116.
54. Sanda MG, Cadeddu JA, Kirkby E, et al. Clinically localized prostate cancer
: AUA/ASTRO/SUO Guideline. Part I: risk stratification, shared decision making, and care options. J Urol 2018; 199:683–690.
55. Piert M, Shankar PR, Montgomery J, et al. Accuracy of tumor segmentation from multiparametric prostate MRI and (18)F-choline PET/CT for focal prostate cancer
therapy applications. EJNMMI Res 2018; 8:23.
56. Eiber M, Weirich G, Holzapfel K, et al. Simultaneous (68)Ga-PSMA HBED-CC PET/MRI improves the localization of primary prostate cancer
. Eur Urol 2016; 70:829–836.
57. Postema AW, Frinking PJ, Smeenge M, et al. Dynamic contrast-enhanced ultrasound parametric imaging for the detection of prostate cancer
. BJU Int 2016; 117:598–603.
58. Ghai S, Eure G, Fradet V, et al. Assessing cancer risk on novel 29 MHz micro-ultrasound images of the prostate: creation of the micro-ultrasound protocol for prostate risk identification. J Urol 2016; 196:562–569.