Making a case "against" focal therapy for intermediate-risk prostate cancer.

World Journal of Urology
Paolo GonteroBadrinath Konety

Abstract

Focal therapy (FT) for localized prostate cancer (PCa) is a promising treatment strategy. Although, according to guidelines, it should be regarded as an experimental option, its introduction into clinical practice has occurred at an accelerated speed. It is, thus, crucial for Urologists to understand FT limitations and potential drawbacks that may derive from its use. We performed a literature search of peer-reviewed English language articles using Pubmed and the words "focal therapy" AND "prostate cancer" to identify relevant articles. Web search was complemented by manual search. From a biological perspective, in contrast with the index lesion theory, which still needs to be better supported, PCa is a multifocal and multiclonal entity. Also, the effects of FT on PCa microenvironment are unclear. From a clinical perspective, patient selection is still not precisely defined. Even when all variables potentially decreasing mpMRI and biopsy accuracy are optimized, up to one out of two men may be incorrectly selected for FT, leaving a significant proportion of clinically significant PCa (csPCa) untreated. Underestimation of PCa volume and variant histologies are other additional mpMRI potential limitations. No RCTs have been perfor...Continue Reading

References

Apr 3, 2008·Current Opinion in Urology·Thomas J Polascik, Vladimir Mouraviev
Oct 23, 2009·The New England Journal of Medicine·Hashim Uddin Ahmed
Dec 26, 2012·European Urology·Johan LindbergHenrik Grönberg
Jun 19, 2013·European Urology·Massimo ValerioThomas J Polascik
Mar 15, 2014·Current Opinion in Urology·Eric BarretXavier Cathelineau
Apr 23, 2014·Nature Reviews. Clinical Oncology·Hashim U AhmedUNKNOWN Prostate Cancer RCT Consensus Group
May 14, 2014·Nature Reviews. Clinical Oncology·Laurence Klotz, Mark Emberton
Feb 19, 2015·Current Opinion in Urology·Marc A Dall'Era
Nov 7, 2015·Cell·UNKNOWN Cancer Genome Atlas Research Network
Jan 19, 2016·European Urology·Arjun Sivaraman, Eric Barret
Sep 7, 2016·European Urology·Massimo ValerioMark Emberton
Jan 10, 2017·Nature·Michael FraserPaul C Boutros
Apr 4, 2018·Nature Genetics·Joshua ArmeniaEliezer M Van Allen
Jun 28, 2018·World Journal of Urology·Kae Jack TayThomas J Polascik
Aug 3, 2018·Abdominal Radiology·Andreas M HötkerOguz Akin
Aug 21, 2018·Current Opinion in Urology·Francesco SoriaPaolo Gontero
Aug 24, 2018·Current Opinion in Urology·Rafael R Tourinho-BarbosaRafael Sanchez-Salas
Sep 29, 2018·Health Technology Assessment : HTA·Freddie C HamdyTom A Leslie
Oct 12, 2018·Urologic Oncology·Giancarlo MarraUNKNOWN EAU-YAU Prostate Cancer Working Party
Oct 16, 2018·Current Opinion in Urology·Fouad AounRoland van Velthoven
Nov 11, 2018·British Journal of Cancer·Nicolas A GiraldoCatherine Sautès-Fridman
Jan 6, 2019·World Journal of Urology·Giancarlo MarraUNKNOWN EAU-YAU Prostate Cancer Working Party

❮ Previous
Next ❯

Citations


❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.