BERKELEY, CA (UroToday.com) - The established treatments for localised prostate cancer include surgical removal of the whole gland using radical prostatectomy, eradication of the tumour with radiotherapy, or ablative methods, e.g. cryotherapy or high intensity-focused ultrasound (HIFU).
In recent years, with earlier identification of the disease when tumour volume is low ( < 1.0 mL), there has been a realisation that treatment could be targeted to specific sites in the prostate gland, i.e. the concept of focal therapy.(1) However, there remain several key issues to be addressed for focal therapy to succeed. Can cancers of clinical significance be reliably identified? Can such lesions be accurately localised? Can these lesions be targeted and ablated with lower morbidity? Finally, can complete ablation be monitored in order to determine treatment success? This concept of focal therapy is barely discussed in current urological guidelines. Therefore the issues of how to identify accurately which areas of the gland are affected by cancer and how to monitor the outcome of focal therapy were issues addressed at a recent consensus meeting of urologists, radiologists, radiation oncologists, and basic researchers. As ultrasonography (US) is one of the main imaging methods in urology, a consensus meeting was held to address the position of US in the diagnosis, treatment, and monitoring of focal therapy. This is the second report made by the group on focal therapy, the previous findings being published in 2010.(2)...View or save the full text Mini Review as a .pdf file
| What's known on the subject? and What does the study add? Focal therapy techniques are emerging in prostate cancer treatment. However, several key questions about patient selection, treatment and monitoring still have to be addressed. The concept of focal therapy is barely discussed in current urological guidelines. In the present manuscript, we report the results of a consensus meeting focused on ultrasonography, the most common used urological imaging method, in relation to focal therapy of prostate cancer. |
Martijn Smeenge,1 Jelle Barentsz,2 David Cosgrove,3 Jean de la Rosette,1 Theo de Reijke,1 Scott Eggener,4 Ferdinand Frauscher,5 Gyoergy Kovacs,6 Surena F. Matin,7 Massimo Mischi,8 Peter Pinto,9 Ardeshir Rastinehad,9 Olivier Rouviere,10 Georg Salomon,11 Thomas Polascik,12 Jochen Walz,13 Hessel Wijkstra,1, 8 and Michael Marberger14
1Department of Urology, AMC University Hospital, Amsterdam, The Netherlands, 2Department of Radiology, Radboud University Medical Centre, Nijmegen, The Netherlands, 3Imaging Sciences Department, Imperial College, London, UK, 4Section of Urology, University of Chicago, Chicago, IL, USA, 5Department of Radiology, Uroradiology, Medical University Innsbruck, Innsbruck, Austria, 6Interdisciplinary Brachytherapy Unit, University of Lubeck, Lubeck, Germany, 7Department of Urology, University of Texas, MD Anderson Cancer Center, Houston, TX, USA, 8Signal Processing Systems, Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands, 9Urologic Oncology Branch, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA, 10 Department of Urinary and Vascular Radiology, Hôpital Edouard Herriot, Lyon, France, 11Martini Clinic, Prostate Cancer Centre, University Hospital Hamburg, Germany, 12 Division of Urologic Surgery, Duke University Medical Center, Durham, NC, USA, 13 Department of Urology, Institut Paoli-Calmettes Cancer Centre, Marseille, France, and 14Department of Urology, Medical University of Vienna, Vienna, Austria
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