#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

FOCAL THERAPY FOR LOCALIZED PROSTATE CANCER


Authors: K. M. Siddiqui;  M. Billia;  J. Izawa;  J. L. Chin
Authors‘ workplace: Division of Surgical Oncology University of Western Ontario
Published in: Urol List 2015; 13(3): 35-40

Overview

The ubiquity of prostate specific antigen testing in certain parts of the world has led to significant stage migration of prostate cancer at presentation, apparently resulting in over-diagnosis and over-treatment. With radical definitive therapies such as radical prostatectomy and radiotherapy, patients have to endure treatment-related adverse effects. “Active surveillance with delayed intervention if necessary”, has gained popularity as a possible solution for the over-treatment problem, although this approach also has inherent limitations. Focal therapy is emerging as a viable management option for certain localized prostate cancers. Advancement in imaging technology coupled with the ability to safely and effectively deliver energy to ablate foci of localized prostate cancer has accelerated acceptance of this form of management. Level one evidence is still lacking, although a number of trials are now underway to define the role of focal therapy. Cryotherapy and high intensity focused ultrasound have an established track record as energy sources for whole gland prostate ablation. In this article we review the indications and technique of focal treatment for localized prostate cancer, as well as early published results using these two technologies.

Key Words:
prostate cancer focal therapy cryoablation high intensity focused ultrasound interstitial laser photodynamic therapy irreversible electroporation and focal brachytherapy


Sources

1. Eggener SE, Scardino PT, Carroll PR et al. International task force on prostate cancer and the focal lesion paradigm. Focal therapy for localized prostate cancer: a critical appraisal of rationale and modalities. J Urol 2007; 178(6): 2260–2267.

2. Valerio M, Ahmed HU, Emberton M et al. The role of focal therapy in the management of localized prostate cancer: a systematic review. Eur Urol 2014; 66(4): 732–751. doi: 10.1016/j.eururo.2013.05.048.

3. Cool DW, Zhang X, Romagnoli C et al. Evaluation of MRI-TRUS fusion versus cognitive registration accuracy for MRI-targeted, TRUS-guided prostate biopsy. AJR Am J Roentgenol 2015; 204(1): 83–91. doi: 10.2214/AJR.14.12681.

4. Tran M, Thompson J, Böhm M et al. Combination of multiparametric MRI and transperineal template-guided mapping biopsy of the prostate to identify candidates for hemi-ablative focal therapy. BJU Int 2015; 193(4): doi:10.1111/bju.13090.

5. Crawford ED, Rove KO, Barqawi AB et al. Clinical--pathologic correlation between transperineal mapping biopsies of the prostate and three-dimen­sional reconstruction of prostatectomy specimens. Prostate 2013; 73(7): 778–787. doi: 10.1002/pros.22622.

6. Cool DW, Connolly MJ, Sherebrin S et al. Repeat prostate biopsy accuracy: simulator-based comparison of two- and three-dimensional transrectal US modalities. Radiology 2010; 254(2): 587–594. doi: 10.1148/radiol.2542090674.

7. Kanthabalan A, Arya M, Punwani S et al. Role of focal salvage ablative therapy in localised radiorecurrent prostate cancer. World J Urol 2013; 31(6): 1361–1368.

8. Chin JL, Pautler SE, Mouraviev V et al. Results of salvage cryoablation of the prostate after radiation: identifying predictors of treatment failure and complications. J Urol 2001; 165 (6 Pt 1): 1937–1942.

9. Chalasani V, Martinez CH, Lim D et al. Salvage HIFU for recurrent prostate cancer after radiotherapy. Prostate Cancer Prostatic Dis 2009; 12(2): 124–129. doi: 10.1038/pcan.2008.53.

10. Ng CK, Moussa M, Downey DB et al. Salvage cryoablation of the prostate: followup and analysis of predictive factors for outcome. J Urol 2007 Oct; 178 (4 Pt 1): 1253–1257.

11. Williams AK, Martínez CH, Lu C et al. Disease--free survival following salvage cryotherapy for ­biopsy-proven radio-recurrent prostate cancer. Eur Urol 2011; 60(3): 405–410. doi: 10.1016/j.eururo.2010.12.012.

12. Uddin Ahmed H, Cathcart P, Chalasani V et al. Whole-gland salvage high-intensity focused ultrasound therapy for localized prostate cancer recur­rence after external beam radiation therapy. Cancer 2012; 118(12): 3071–3078. doi: 10.1002/cncr.26631.

13. Soanes WA, Gander MJ, Shulman S. Apparatus and techniques for cryosurgery of the prostate. J Urol 1966; 96(4): 508–511.

14. Chin JL, Downey DB, Onik G et al. Three-dimensional prostate ultrasound and its applica­tion to cryosurgery. Tech Urol 1996; 2(4): 187–193.

15. Chin JL, Downey DB, Mulligan M et al. Three-dimensional transrectal ultrasound guided cryo­ablation for localized prostate cancer in nonsurgical candidates: a feasibility study and report of early results. J Urol 1998; 159(3): 910–914.

16. Bahn DK, Silverman P, Lee F Sr et al. Focal prostate cryoablation: initial results show cancer control and potency preservation. J Endourol 2006 Sep; 20(9): 688–692.

17. Lambert EH, Bolte K, Masson P et al. Focal cryosurgery: encouraging health outcomes for unifocal prostate cancer. Urology 2007; 69(6): 1117–1120.

18. Ellis DS, Manny TB Jr, Rewcastle JC. Focal cryosurgery followed by penile rehabilitation as primary treat­ment for localized prostate cancer: initial results. Urology 2007; 70 (Suppl 6): 9–15. doi: 10.1016/j.urology.2007.07.036.

19. Onik G, Vaughan D, Lotenfoe R et al. 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): 500–505. doi: 10.1016/j.urolonc.2008.03.004.

20. Barqawi AB, Stoimenova D, Krughoff K et al. Targeted focal therapy for the management of organ confined prostate cancer. J Urol 2014; 192(3): 749–753. doi: 10.1016/j.juro.2014.03.033.

21. Ward JF, Jones JS. Focal cryotherapy for localized prostate cancer: a report from the nation­al Cryo On-Line Database (COLD) Registry. BJU Int 2012; 109(11): 1648–1654. doi: 10.1111/j.1464-410X.2011.10578.x.

22. Ballantine Ht Jr, Hueter TF, Nauta WJ et al. Focal destruction of nervous tissue by focused ultrasound: biophysical factors influencing its application. J Exp Med 1956; 104(3): 337–360.

23. Clement GT. Perspectives in clinical uses of high-intensity focused ultrasound. Ultrasonics 2004; 42(10): 1087–1093.

24. Ter Haar GR, Robertson D. Tissue destruction with focused ultrasound in vivo. Eur Urol 1993; 23 (Suppl 1): 8–11.

25. Muto S, Yoshii T, Saito K et al. Focal ­therapy with high-intensity-focused ultrasound in the treat­ment of localized prostate cancer. Jpn J Clin Oncol 2008; 38(3): 192–199. doi: 10.1093/jjco/hym173.

26. Murat FJ, Cherasse A, Poissonnier L et al. Focal therapy of prostate cancer (PCa) with HIFU: ­influence on erectile dysfunction (ED). Eur Urol Suppl 2009; 8: 334.

27. Dickinson L, Ahmed HU, McCartan N et al. Medium term outcomes following primary focal ther­apy using HIFU for localized prostate cancer. BJU Int 2012; 109(7): 6.

28. Ahmed HU, Cathcart P, McCartan N et al. Focal salvage therapy for localized prostate cancer recurrence after external beam radiotherapy: a ­pilot study. Cancer 2012; 118(17): 4148–4155. doi: 10.1002/cncr.27394.

29. El Fegoun AB, Barret E, Prapotnich D et al. Focal therapy with highintensity focused ultrasound for prostate cancer in the elderly. A feasibility study with 10 years follow-up. Int Braz J Urol 2011; 37(2): 213–219.

30. Ahmed HU, Freeman A, Kirkham A et al. Focal therapy for localized prostate cancer: a phase I/II ­trial. J Urol 2011; 185(4): 1246–1254. doi: 10.1016/j.juro.2010.11.079.

Labels
Paediatric urologist Urology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#