Assessment after focal therapy: what is the latest?

Journal Article (Journal Article;Review)

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.

Full Text

Duke Authors

Cited Authors

  • Kotamarti, S; Séguier, D; Arcot, R; Polascik, TJ

Published Date

  • May 1, 2022

Published In

Volume / Issue

  • 32 / 3

Start / End Page

  • 260 - 266

PubMed ID

  • 35275100

Electronic International Standard Serial Number (EISSN)

  • 1473-6586

Digital Object Identifier (DOI)

  • 10.1097/MOU.0000000000000988


  • eng

Conference Location

  • United States