Assessment after focal therapy: what is the latest?. Issue 3 (11th May 2022)

• Record Type: Journal Article
• Authors: Kotamarti, Srinath; Séguier, Denis; Arcot, Rohith; Polascik, Thomas J.
• Is Part Of: Current opinion in urology. Volume 32:Issue 3(2022)
• Page Start: 260
• Page End: 266
• Publication Date: 2022-05-11
• Subjects: ablation -- assessment -- focal therapy -- prostate cancer -- surveillance; Urology -- Periodicals; Review Literature -- Bibliography; Review Literature -- Periodicals; Male Urogenital Diseases -- Bibliography; Male Urogenital Diseases -- Periodicals; Female Urogenital Diseases -- Bibliography; Female Urogenital Diseases -- Periodicals; Urologic Diseases -- Bibliography; Urologic Diseases -- Periodicals; Periodicals; 616.6005
• DOI: 10.1097/MOU.0000000000000988
• Languages: English
• ISSNs: 1473-6586

Abstract

Abstract : Purpose of review: To review assessment after focal therapy (FT) in the context of developments from the past two years. Recent findings: With a paucity of high-quality studies, recent findings are primarily reliant on results from institutional-based cohorts and reports of expert consensus. Notably, oncologic treatment failure should be further stratified into recurrence in the in-field or out-of-field ablation zone, and both regions should be surveilled postoperatively. Monitoring primarily consists of periodic evaluations of prostate-specific antigen (PSA) testing and magnetic resonance imaging, with histologic sampling needed to confirm suspicion of recurrence. Recent investigations into PSA derivatives, contrast-enhanced ultrasound, and prostate-specific membrane antigen imaging have shown preliminary promise. Although postablation functional outcomes are generally accepted to be excellent, they are limited by the wide range of patient-reported measures, variability in individual practice, and low questionnaire completion rates. Summary: There is still a need for high-level, long-term data to inform exact standardized protocols to manage patients after FT. A multifaceted approach is required to surveil patients and identify those at risk of recurrence. Embracing shared responsibility between the patient and clinician to fastidiously monitor the infield and out-of-field ablation zones postoperatively is critical to maximize oncologic outcomes.