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Histological outcomes after focal high-intensity focused ultrasound and cryotherapy

INTRODUCTION: Focal therapy has increasingly become an accepted treatment option for patients with localised prostate cancer. Most follow-up protocols use a mixture of protocol biopsies or “for cause” biopsies triggered by a rising PSA. In this paper, we discuss the histological outcomes from these...

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Autores principales: Shah, Taimur T., Kasivisvanathan, Veeru, Jameson, Charles, Freeman, Alex, Emberton, Mark, Ahmed, Hashim U.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480821/
https://www.ncbi.nlm.nih.gov/pubmed/25944676
http://dx.doi.org/10.1007/s00345-015-1561-0
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author Shah, Taimur T.
Kasivisvanathan, Veeru
Jameson, Charles
Freeman, Alex
Emberton, Mark
Ahmed, Hashim U.
author_facet Shah, Taimur T.
Kasivisvanathan, Veeru
Jameson, Charles
Freeman, Alex
Emberton, Mark
Ahmed, Hashim U.
author_sort Shah, Taimur T.
collection PubMed
description INTRODUCTION: Focal therapy has increasingly become an accepted treatment option for patients with localised prostate cancer. Most follow-up protocols use a mixture of protocol biopsies or “for cause” biopsies triggered by a rising PSA. In this paper, we discuss the histological outcomes from these biopsies and their use in guiding subsequent management and trial development. METHODS: We conducted a literature search and reviewed the post-treatment biopsy results from studies on focal HIFU and focal cryotherapy. We subsequently reviewed the results of three recently published consensus statements released discussing many of the issues concerning focal therapy. RESULTS: Research suggests that 1 in 5 of all post-treatment biopsies after focal therapy are positive. However, the majority of these seemed to be from the untreated portion of the gland or met criteria for clinically insignificant disease. The histological outcomes from focal therapy are promising and confirm its effectiveness in the short to medium term. Furthermore re-treatment is possible whilst maintaining a low-side-effect profile. CONCLUSION: Debate is ongoing about the clinical significance of various levels of residual disease after focal therapy and the exact threshold at which to call failure within a patient who has had focal therapy.
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spelling pubmed-44808212015-07-02 Histological outcomes after focal high-intensity focused ultrasound and cryotherapy Shah, Taimur T. Kasivisvanathan, Veeru Jameson, Charles Freeman, Alex Emberton, Mark Ahmed, Hashim U. World J Urol Topic Paper INTRODUCTION: Focal therapy has increasingly become an accepted treatment option for patients with localised prostate cancer. Most follow-up protocols use a mixture of protocol biopsies or “for cause” biopsies triggered by a rising PSA. In this paper, we discuss the histological outcomes from these biopsies and their use in guiding subsequent management and trial development. METHODS: We conducted a literature search and reviewed the post-treatment biopsy results from studies on focal HIFU and focal cryotherapy. We subsequently reviewed the results of three recently published consensus statements released discussing many of the issues concerning focal therapy. RESULTS: Research suggests that 1 in 5 of all post-treatment biopsies after focal therapy are positive. However, the majority of these seemed to be from the untreated portion of the gland or met criteria for clinically insignificant disease. The histological outcomes from focal therapy are promising and confirm its effectiveness in the short to medium term. Furthermore re-treatment is possible whilst maintaining a low-side-effect profile. CONCLUSION: Debate is ongoing about the clinical significance of various levels of residual disease after focal therapy and the exact threshold at which to call failure within a patient who has had focal therapy. Springer Berlin Heidelberg 2015-05-06 2015 /pmc/articles/PMC4480821/ /pubmed/25944676 http://dx.doi.org/10.1007/s00345-015-1561-0 Text en © The Author(s) 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Topic Paper
Shah, Taimur T.
Kasivisvanathan, Veeru
Jameson, Charles
Freeman, Alex
Emberton, Mark
Ahmed, Hashim U.
Histological outcomes after focal high-intensity focused ultrasound and cryotherapy
title Histological outcomes after focal high-intensity focused ultrasound and cryotherapy
title_full Histological outcomes after focal high-intensity focused ultrasound and cryotherapy
title_fullStr Histological outcomes after focal high-intensity focused ultrasound and cryotherapy
title_full_unstemmed Histological outcomes after focal high-intensity focused ultrasound and cryotherapy
title_short Histological outcomes after focal high-intensity focused ultrasound and cryotherapy
title_sort histological outcomes after focal high-intensity focused ultrasound and cryotherapy
topic Topic Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4480821/
https://www.ncbi.nlm.nih.gov/pubmed/25944676
http://dx.doi.org/10.1007/s00345-015-1561-0
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