Identifying the best candidate for focal therapy: a comprehensive review.

IF 5.1 2区 医学 Q1 ONCOLOGY
Alireza Ghoreifi, Leonard Gomella, Jim C Hu, Badrinath Konety, Luca Lunelli, Ardeshir R Rastinehad, Georg Salomon, Samir Taneja, Rafael Tourinho-Barbosa, Amir H Lebastchi
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引用次数: 0

Abstract

Background: Despite the evidence supporting the use of focal therapy (FT) in patients with localized prostate cancer (PCa), considerable variability exists in the patient selection criteria across current studies. This study aims to review the most recent evidence concerning the optimal approach to patient selection for FT in PCa.

Methods: PubMed database was systematically queried for studies reporting patient selection criteria in FT for PCa before December 31, 2023. After excluding non-relevant articles and a quality assessment, data were extracted, and results were described qualitatively.

Results: There is no level I evidence regarding the best patient selection approach for FT in patients with PCa. Current international multidisciplinary consensus statements recommend multiparametric magnetic resonance imaging (mpMRI) followed by MRI-targeted and systematic biopsy for all candidates. FT may be considered in clinically localized, intermediate risk (Gleason 3 + 4 and 4 + 3), and preferably unifocal disease. Patients should have an acceptable life expectancy. Those with prostate volume >50 ml and erectile dysfunction should not be excluded from FT. Prostate-specific antigen (PSA) level of < 20 (ideally < 10) ng/mL is recommended. However, the utility of other molecular and genomic biomarkers in patient selection for FT remains unknown.

Conclusions: FT may be considered in well-selected patients with localized PCa. This review provides a comprehensive insight regarding the optimal approach for patient selection in FT.

确定病灶治疗的最佳人选:全面回顾。
背景:尽管有证据支持在局部前列腺癌(PCa)患者中使用病灶治疗(FT),但目前的研究在患者选择标准方面存在很大差异。本研究旨在回顾有关PCa患者病灶治疗最佳选择方法的最新证据:方法:系统查询了 PubMed 数据库中 2023 年 12 月 31 日之前报道 PCa FT 患者选择标准的研究。在排除非相关文章并进行质量评估后,提取数据并对结果进行定性描述:结果:目前尚无I级证据表明,PCa患者进行FT治疗的最佳患者选择方法。目前国际多学科共识声明建议对所有候选者进行多参数磁共振成像(mpMRI),然后进行磁共振成像靶向和系统活检。对于临床定位、中度风险(Gleason 3 + 4 和 4 + 3)且最好是单灶疾病,可考虑进行 FT。患者应有可接受的预期寿命。前列腺体积大于 50 毫升且有勃起功能障碍的患者不应被排除在前列腺癌治疗范围之外。前列腺特异性抗原(PSA)水平结论:对于经过严格筛选的局部 PCa 患者,可考虑进行前列腺癌根治术。本综述全面阐述了选择前列腺癌患者的最佳方法。
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来源期刊
Prostate Cancer and Prostatic Diseases
Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学
CiteScore
10.00
自引率
6.20%
发文量
142
审稿时长
6-12 weeks
期刊介绍: Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.
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