Focal therapy in prostate cancer-report from a consensus panel.
Abstract
PURPOSE: To establish a consensus in relation to case selection, conduct of therapy,
and outcomes that are associated with focal therapy for men with localized prostate
cancer. MATERIAL AND METHODS: Urologic surgeons, radiation oncologists, radiologists,
and histopathologists from North America and Europe participated in a consensus workshop
on focal therapy for prostate cancer. The consensus process was face to face within
a structured meeting, in which pertinent clinical issues were raised, discussed, and
agreement sought. Where no agreement was possible, this was acknowledged, and the
nature of the disagreement noted. RESULTS: Candidates for focal treatment should have
unilateral low- to intermediate-risk disease with clinical stage <or=cT(2a). Prostate
size and both tumor volume and tumor topography are important case selection criteria
that depend on the ablative technology used. Currently, the best method to ascertain
the key characteristics for men who are considering focal therapy is exposure to transperineal
template mapping biopsies. MRI of the prostate using novel techniques such as dynamic
contrast enhancement and diffusion weighed imaging are increasingly being used to
diagnose and stage primary prostate cancer with excellent results. For general use,
however, these new techniques require validation in prospective clinical trials. Until
such are performed, MRI will, in most centers, continue to be an investigative tool
in assessing eligibility of patients for focal therapy. CONCLUSIONS: Consensus was
derived for most of the key aspects of case selection, conduct of treatment, and outcome
measures for men who are undergoing focal therapy for localized prostate cancer. The
level of agreement achieved will pave the way for future collaborative trials.
Type
Journal articlePermalink
https://hdl.handle.net/10161/3299Published Version (Please cite this version)
10.1089/end.2009.0596Publication Info
de la Rosette, J; Ahmed, H; Barentsz, J; Johansen, T Bjerklund; Brausi, M; Emberton,
M; ... Polascik, T (2010). Focal therapy in prostate cancer-report from a consensus panel. J Endourol, 24(5). pp. 775-780. 10.1089/end.2009.0596. Retrieved from https://hdl.handle.net/10161/3299.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Thomas James Polascik
Professor of Surgery
Prostate cancer imaging Focal therapy of prostate cancer Prostate cancer outcomes
Kidney cancer outcomes Minimally invasive surgery Nerve sparing cryotherapy

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