title: [Focal therapy and prostate cancer].
abstract: The International Task Force on Prostate Cancer defines focal therapy (FT) for prostate cancer (PCa) as the therapy that "selectively ablates known disease and preserves existing functions, with the overall objective of minimizing lifetime morbidity without compromising life expectancy". FT for the treatment of PCa has been called the "male lumpectomy", an analogue to women's breast lumpectomy for the treatment of breast cancer. Radical prostatectomy continues to be the most frequently performed treatment for localized PCa, as anatomic knowledge and several technical advances, i.e. the introduction of robotic assisted surgery, have led to successful oncological outcome and lower rates of post-treatment morbidity. However, a proportion of patients still experiences a no negligible sexual, urinary, and bowel morbidity. Although the rationale of active surveillance for low-risk PCa (PSA <10 ng/mL, Gleason grade 6 or less, and clinical stage T1c-T2a) is sound, only few of newly diagnosed patients elect this approach. Thus, in the recent years the concept of a "subtotal therapy" gained the interest of some urological schools. The aim of this paper is to review the existing literature in order to provide the status of art on FT for PCa. The manuscript will focus on the characteristics of the target population, on the pre-operative evaluation to localise disease, as well as on perioperative, functional, and disease-control following focal therapy.
authors.affiliation: Department of Urology, San Raffaele Turro, Vita-Salute San Raffaele University, Milan - Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Lazzeri
authors.forename: Andrea
authors.initials: A
authors.lastname: Losa
authors.forename: Nicolòmaria
authors.initials: N
authors.lastname: Buffi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Lughezzani
authors.forename: Nicola
authors.initials: N
authors.lastname: Fossati
authors.forename: Alberto
authors.initials: A
authors.lastname: Abrate
authors.forename: Alessandro
authors.initials: A
authors.lastname: Larcher
authors.forename: Giuliana
authors.initials: G
authors.lastname: Lista
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mistretta
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D001918:Brachytherapy / Q000379:methods*; D003452:Cryosurgery / Q000379:methods; D057086:High-Intensity Focused Ultrasound Ablation; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D018579:Patient Selection; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D012371:Robotics; D016896:Treatment Outcome