Tourinho-Barbosa Rafael R, Batista Lucas Teixeira, Cathelineau Xavier, Sanchez-Macias Javier, Sanchez-Salas Rafael
Department of Urology, Institute Mutualiste Montsouris, Université Paris-Descartes, Paris, France.
Department of Urology, Faculdade de Medicina do ABC, Santo André, Brazil.
Turk J Urol. 2021 Feb;47(Supp. 1):S49-S55. doi: 10.5152/tud.2020.20390. Epub 2020 Oct 9.
This review provides an overview of the available ablative options for prostate cancer (PCa) management. It contemplates the ablative concepts and the role of prostate ablation in different settings, from primary treatment to repeat ablation, and as an alternative to radiorecurrent disease. Improvements in prostate imaging have allowed us to ablate prostate lesions through thermal, mechanical, and vascular-targeted sources of energy. Partial gland ablation (PGA) has an emerging role in the management of localized PCa because toxicity outcomes have been proven less harmful compared with whole-gland treatments. Although long-term oncological outcomes are yet to be consolidated in comparative studies, recent large series and prospective studies in PGA have reported encouraging results. A second ablation after disease recurrence has demonstrated low toxicity, and future studies must define its potential to avoid radical treatments. PGA is an attractive option for PCa management in different scenarios because of its low-toxicity profile. As expected, recurrence rates are higher than those seen in whole-gland procedures. Long-term oncological outcomes of primary and salvage options are required to endorse it among the standard treatments.
本综述概述了前列腺癌(PCa)治疗中现有的消融治疗选择。它探讨了消融治疗的概念以及前列腺消融在不同情况下的作用,从初始治疗到重复消融,以及作为放射性复发性疾病的替代治疗。前列腺成像技术的进步使我们能够通过热、机械和血管靶向能量源对前列腺病变进行消融。部分腺体消融(PGA)在局限性PCa的治疗中发挥着越来越重要的作用,因为与全腺体治疗相比,其毒性结果已被证明危害较小。尽管长期肿瘤学结果在比较研究中尚未得到证实,但最近关于PGA的大型系列研究和前瞻性研究报告了令人鼓舞的结果。疾病复发后的二次消融已显示出低毒性,未来的研究必须确定其避免根治性治疗的潜力。由于其低毒性特征,PGA在不同情况下都是PCa治疗的一个有吸引力的选择。正如预期的那样,复发率高于全腺体手术。需要原发性和挽救性治疗方案的长期肿瘤学结果,以使其在标准治疗中得到认可。