title: Focal therapy as primary treatment for localized prostate cancer: definition, needs and future.
abstract: Focal therapy (FT) may offer a promising treatment option in the field of low to intermediate risk localized prostate cancer. The aim of this concept is to combine minimal morbidity with cancer control as well as maintain the possibility of retreatment. Recent advances in MRI and targeted biopsy has improved the diagnostic pathway of prostate cancer and increased the interest in FT. However, before implementation of FT in routine clinical practice, several challenges are still to overcome including patient selection, treatment planning, post-therapy monitoring and definition of oncologic outcome surrogates. In this article, relevant questions regarding the key steps of FT are critically discussed and the main available energy modalities are analyzed taking into account their advantages and unmet needs.
authors.affiliation: Department of Urology, CHRU de Lille, Hôpital Claude Huriez, F-59037 Lille, France.|NSERM, U1189, ONCO-THAI, F-59037 Lille, France.
authors.forename: Adil
authors.initials: A
authors.lastname: Ouzzane
authors.affiliation: NSERM, U1189, ONCO-THAI, F-59037 Lille, France.
authors.forename: Nacim
authors.initials: N
authors.lastname: Betrouni
authors.affiliation: Department of Urology, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
authors.forename: Massimo
authors.initials: M
authors.lastname: Valerio
authors.affiliation: Icahn School of Medicine at Mount Sinai New York, New York, NY, USA.
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Rastinehad
authors.affiliation: Department of Urology, Hôpital Privé de la Louvière, Ramsay Générale de Santé, 59000 Lille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Colin
authors.affiliation: Institut universitaire du Cancer de Toulouse - Oncopole, Toulouse, France.|Department of Urology, Saint-Jean Languedoc Hospital, Toulouse, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
mesh_terms: D001706:Biopsy; D003131:Combined Modality Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D019233:Retreatment; D017211:Treatment Failure; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: HIFU; MRI; ablation; cryotherapy; focal therapy; imaging; laser; prostate cancer; urologic/prostate; watchful waiting