Contemporary outcomes of focal therapy in prostate cancer: what do we know so far..

INTRODUCTION

Despite the enthusiasm for an organ preserving approach to prostate cancer treatment, studies that support the supposition that this approach will offer patients the "Trifecta" of prostate cancer therapy are lacking.

METHODS

Review of published peer review literature using a combination of the terms "Focal", "Prostate Cancer", "Therapy", "Cryoablation", "HIFU", and "Clinical Trial".

RESULTS

To date only three prospective clinical trials of subtotal prostate cryoablation and one of subtotal high-intensity focused ultrasound (HIFU) have been reported along with one retrospective review of patients treated in a subtotal manner with cryotherapy. In total, these reports present only 166 patients. All current strategies for focally ablative therapy for prostate cancer treatment have varied in their eligibility criteria and in the amount of tissue targeted for destruction and/or preservation.

CONCLUSIONS

Very little is published on either the oncologic outcomes or quality-of-life outcomes following subtotal prostate ablation to justify its growing popularity with both patients and physicians. Significant research and clinical trials that examine patient selection, biopsy strategies, and ablative energies, along with oncologic efficacy and quality-of-life outcomes are needed. This article will review the current state of knowledge regarding subtotal prostate ablative strategies.