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Selection Criteria for Focal Therapy of Prostate Cancer

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Imaging and Focal Therapy of Early Prostate Cancer

Part of the book series: Current Clinical Urology ((CCU))

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Abstract

A comprehensive literature review along with our own data was performed to establish selection criteria for focal therapy (FT) of localized prostate cancer (PCa) as a feasible modality in contemporary urological oncology. Recent data have demonstrated a significant pathologic stage migration towards earlier disease comprising unilateral pT2a/b PCa. The cancer volume of the clinically significant tumor (index lesion) has been proposed as a driving force of PCa progression and therefore should be identified and treated at an early stage. In general, the majority of secondary lesions do not appear to be life threatening to the patient. Some clinical and pathologic features such as clinical stage, baseline PSA, preoperative image-guided saturation, or multicore biopsy of the prostate (3D-TRUS or multiparametric MRI), with precise mapping of the spatial distribution of PCa within the prostate, remain important selective criteria for FT. Based on the current understanding of the tumor biology of early stage disease and promising outcomes of the first single- and two-institution trials, a solid background for the different types of ablation for early stage PCa has been created. While the identification of a unifocal lesion preoperatively is currently a challenging process, the detection of unilateral lesions seems to be a more feasible option with subsequent hemi-ablative treatment of the prostate.

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Author information

Authors and Affiliations

  1. Division of Urology/Department of Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, ML 0589, Cincinnati, OH, 45267, USA

    Vladimir Mouraviev M.D., Ph.D.

  2. Departments of Surgery, Urological Surgery, Duke Cancer Institute, Duke University Medical Center, Room 1089 Duke South, 2804, Durham, NC, 27710, USA

    Thomas J. Polascik M.D.,F.A.C.S.

Authors
  1. Vladimir Mouraviev M.D., Ph.D.
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  2. Thomas J. Polascik M.D.,F.A.C.S.
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Corresponding author

Correspondence to Thomas J. Polascik M.D.,F.A.C.S. .

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Editors and Affiliations

  1. , Department of Surgery, Duke Cancer Institute, Room 1089 Duke South, Durham, 27710, North Carolina, USA

    Thomas J. Polascik

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Mouraviev, V., Polascik, T.J. (2013). Selection Criteria for Focal Therapy of Prostate Cancer. In: Polascik, T. (eds) Imaging and Focal Therapy of Early Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-182-0_18

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  • DOI: https://doi.org/10.1007/978-1-62703-182-0_18

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  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-62703-181-3

  • Online ISBN: 978-1-62703-182-0

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