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Focal therapy for prostate cancer

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https://www.readbyqxmd.com/read/27882770/focal-therapy-as-primary-treatment-for-localized-prostate-cancer-definition-needs-and-future
#1
Adil Ouzzane, Nacim Betrouni, Massimo Valerio, Ardeshir Rastinehad, Pierre Colin, Guillaume Ploussard
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...
November 24, 2016: Future Oncology
https://www.readbyqxmd.com/read/27846402/focal-therapy-in-prostate-cancer-a-review-of-seven-common-controversies
#2
REVIEW
Edward J Bass, Hashim U Ahmed
Radical treatments such as prostatectomy and radiotherapy have demonstrated success in terms of biochemical and disease-specific survival for localised prostate cancer. However, whilst the end goal of any cancer treatment is to control or cure disease it must also do so by minimising any side effects that may be experienced by the patient. Focal therapy as a concept aims to redress this established therapeutic ratio by treating areas of the prostate affected by significant disease as opposed to treating the entire gland...
July 18, 2016: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/27844131/-mri-trus-fusion-guided-prostate-biopsy-value-in-the-context-of-focal-therapy
#3
T Franz, J von Hardenberg, A Blana, H Cash, D Baumunk, G Salomon, B Hadaschik, T Henkel, J Herrmann, F Kahmann, K-U Köhrmann, J Köllermann, S Kruck, U-B Liehr, S Machtens, I Peters, J P Radtke, A Roosen, H-P Schlemmer, L Sentker, J J Wendler, U Witzsch, J-U Stolzenburg, M Schostak, R Ganzer
BACKGROUND: Several systems for MRI/TRUS fusion-guided biopsy of the prostate are commercially available. Many studies have shown superiority of fusion systems for tumor detection and diagnostic quality compared to random biopsy. The benefit of fusion systems in focal therapy of prostate cancer (PC) is less clear. OBJECTIVES: Critical considerations of fusion systems for planning and monitoring of focal therapy of PC were investigated. MATERIALS AND METHODS: A systematic literature review of available fusion systems for the period 2013-5/2016 was performed...
November 14, 2016: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/27825432/psma-pet-and-radionuclide-therapy-in-prostate-cancer
#4
REVIEW
Kirsten Bouchelouche, Baris Turkbey, Peter L Choyke
Prostate cancer (PCa) is the most common malignancy in men and a major cause of cancer death. Accurate imaging plays an important role in diagnosis, staging, restaging, detection of biochemical recurrence, and for therapy of patients with PCa. Because no effective treatment is available for advanced PCa, there is an urgent need to develop new and more effective therapeutic strategies. To optimize treatment outcome, especially in high-risk patients with PCa, therapy for PCa is moving rapidly toward personalization...
November 2016: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/27814981/hemi-gland-focal-low-dose-rate-prostate-brachytherapy-an-analysis-of-dosimetric-outcomes
#5
Robert Laing, Adrian Franklin, Jennifer Uribe, Alex Horton, Santiago Uribe-Lewis, Stephen Langley
BACKGROUND AND PURPOSE: Advances in magnetic resonance imaging (MRI) and prostate sampling enable early identification of men with low to intermediate risk prostate cancer who are candidates for focal therapies that minimise side effects. We report dosimetry data from a pilot study evaluating the effectiveness of hemi-gland low dose rate (HG-LDR) brachytherapy as a focal therapy approach to control unilateral localised disease. MATERIAL AND METHODS: Twenty-two men underwent HG-LDR brachytherapy...
November 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27809594/outcomes-and-toxicities-in-patients-treated-with-definitive-focal-therapy-for-primary-prostate-cancer-systematic-review
#6
Atallah Baydoun, Bryan Traughber, Nathan Morris, Michella Abi Zeid Daou, Michael McGraw, Tarun K Podder, Raymond F Muzic, Simon S Lo, Lee E Ponsky, Mitchell Machtay, Rodney Ellis
AIM: This systematic review summarizes the clinical data on focal therapy (FT) when used alone as definitive therapy for primary prostate cancer (PCa). METHODS: The protocol is detailed in the online PROSPERO database, registration No. CRD42014014765. Articles evaluating any form of FT alone as a definitive treatment for PCa in adult male patients were included. RESULTS: Of 10,419 identified articles, 10,401 were excluded, and thus leaving 18 for analysis...
November 4, 2016: Future Oncology
https://www.readbyqxmd.com/read/27799004/comparing-high-intensity-focal-ultrasound-hemiablation-to-robotic-radical-prostatectomy-in-the-management-of-unilateral-prostate-cancer-a-matched-pair-analysis
#7
Simone Albisinni, Fouad Aoun, Simon Bellucci, Ibrahim Biaou, Ksenija Limani, Eric Hawaux, Alexandre Peltier, Roland van Velthoven
INTRODUCTION: Although still experimental, focal treatment is being increasingly implemented in the management of prostate cancer (PCa). Aim of the current study was to compare functional and oncologic outcomes of high-intensity focal ultrasound (HIFU) hemiablation of the prostate to robot-assisted laparoscopic prostatectomy (RALP) in the management of unilateral PCa. MATERIALS: Fifty-five men with unilateral, clinically localized PCa underwent HIFU hemiablation of the affected prostatic lobe between 2007 and 2015...
November 30, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27776423/mri-guided-focal-therapy-of-prostate-cancer
#8
Melvy Sarah Mathew, Aytekin Oto
With the advent of focal therapy as a recognized treatment option for men with prostate cancer, there are a host of emerging interventions that take advantage of MRI for image guidance. Focal therapy affords a middleground option for patients with low- to intermediate-grade prostate cancer by providing a means of keeping their cancer at bay while avoiding the negative consequences of radical therapies. However, the practice of focal treatment is far from straightforward, with some believing focal treatment errs on the side of overtreatment among patients with low-grade cancer; others worry it is undertreatment in potentially significant multifocal disease...
October 25, 2016: Future Oncology
https://www.readbyqxmd.com/read/27761805/focal-therapy-for-prostate-cancer-pending-questions
#9
REVIEW
Xavier Cathelineau, Rafael Sanchez-Salas
Focal therapy (FT) represents a potential shift in clinical practice by featuring a tissue-sparing approach for prostate cancer (PCa) treatment. It stands midway between active surveillance (AS) and more aggressive options like radical prostatectomy (RP) or radiotherapy. The field has enormously evolved in the last few years but there are still pending questions to answer in the future. The manuscript overlooks FT in terms of indications, available energies, situation of tumor microenvironment, follow-up, re-interventions, and the future of this approach for PCa...
December 2016: Current Urology Reports
https://www.readbyqxmd.com/read/27729992/salvage-local-therapy-for-radiation-recurrent-prostate-cancer-where-are-we
#10
Romuald Zdrojowy, Janusz Dembowski, Bartosz Małkiewicz, Krzysztof Tupikowski, Wojciech Krajewski
INTRODUCTION: Prostate cancer is the most frequent cancer among males in Europe and a leading cause of cancer deaths, with similar proportion in other developed countries. For more than twenty years, external-beam radiation therapy, alongside with radical prostatectomy, has been used as a primary radical therapeutic approach for localized prostate cancer. Yet, EBRT failures relate to 22-69% following curative radiotherapy (± androgen deprivation therapy). Additionally, a proportion of these men will have a biopsy-proven local recurrence...
2016: Central European Journal of Urology
https://www.readbyqxmd.com/read/27708117/deflection-analysis-of-different-needle-designs-for-prostate-biopsy-and-focal-therapy
#11
Nelson N Stone, Vladimir Mouraviev, David Schechter, Josh Goetz, M Scott Lucia, E Erin Smith, E David Crawford
OBJECTIVE: The biopsy needles currently used were designed for a transrectal biopsy and are known to experience significant deflection from the point of entry into the gland to the needle tip. METHODS: Five designs were selected for testing: 18-gauge Bard, 15-gauge lancet tip needle with 12° vet-point cannula, and trocar tip needle with 12°, 15°, and 20° vet-point cannulas. The 15-gauge needle was designed to take a variable specimen sample between 20 and 60 mm, whereas the Bard needle specimen bed was fixed at 20 mm...
October 5, 2016: Technology in Cancer Research & Treatment
https://www.readbyqxmd.com/read/27694167/pet-of-glucose-metabolism-and-cellular-proliferation-in-prostate-cancer
#12
Hossein Jadvar
Imaging of the Warburg effect, which is the principal but not the sole cause for enhanced glucose metabolism in tumors, with PET and (18)F-FDG has become the mainstay for the imaging evaluation of several cancers. Despite the seemingly prevalent notion that (18)F-FDG PET may not be useful in prostate cancer, relatively limited evidence suggests that this imaging modality can be useful for the evaluation of the extent of metastatic disease and the assessment of the therapy response and prognosis in men with castration-resistant prostate cancer...
October 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/27693448/pten-loss-in-gleason-score-3-4-7-prostate-biopsies-is-associated-with-non-organ-confined-disease-at-radical-prostatectomy
#13
Liana B Guedes, Jeffrey J Tosoian, Jessica Hicks, Ashley E Ross, Tamara L Lotan
PURPOSE: Men with intermediate risk prostate cancer have widely variable outcomes, with some suggesting that active surveillance or less invasive therapies (brachytherapy or focal therapy) may be appropriate for some men with Gleason Score 3+4=7 disease. Molecular markers may help further distinguish prostate cancers with aggressive behavior. Here, we tested whether loss of the PTEN tumor suppressor in 3+4=7 tumor biopsies is associated with adverse pathology at prostatectomy. MATERIALS AND METHODS: We queried prostate needle biopsies from 2000-2014 with a maximum Gleason score of 3+4=7 followed by prostatectomy...
September 27, 2016: Journal of Urology
https://www.readbyqxmd.com/read/27674221/outcomes-and-toxicities-in-patients-treated-with-definitive-focal-therapy-for-primary-prostate-cancer-a-systematic-review
#14
A Baydoun, B Traughber, N Morris, M McGraw, T K Podder, R F Muzic, S S Lo, L Ponsky, M Machtay, R J Ellis
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27674141/establishing-predictors-of-satellite-lesions-in-men-with-intermediate-and-high-risk-prostate-cancer-for-improved-patient-selection-for-focal-and-focused-therapy
#15
J V Hegde, J Wang, D Margolis, J Huang, M Kamrava
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27670618/an-update-on-focal-therapy-for-prostate-cancer
#16
REVIEW
Marlon Perera, Nishanth Krishnananthan, Uri Lindner, Nathan Lawrentschuk
Globally, the increased uptake of serum PSA level screening led to an increase in the number of diagnoses of low-risk and intermediate-risk prostate cancer. Traditionally, these patients have been considered for either active surveillance programmes or radical whole-gland therapies, such as prostatectomy or radiotherapy. Focal therapy is an emerging treatment option that involves the focal ablation of prostate cancer with preservation of surrounding healthy tissue. This approach might result in reduced morbidity when compared with whole-gland therapies...
November 2016: Nature Reviews. Urology
https://www.readbyqxmd.com/read/27663393/prostate-specific-antigen-vs-magnetic-resonance-imaging-parameters-for-assessing-oncological-outcomes-after-high-intensity-focused-ultrasound-focal-therapy-for-localized-prostate-cancer
#17
Louise Dickinson, Hashim U Ahmed, Richard G Hindley, Neil McCartan, Alex Freeman, Clare Allen, Mark Emberton, Alex P Kirkham
INTRODUCTION: Focal therapy for localized prostate cancer has the potential for oncological control without the side effects of radical therapies. However, there is currently no validated method for monitoring treatment success. We assessed the diagnostic performance of prostate-specific antigen (PSA) parameters and MRI compared to histological outcomes following focal therapy. PATIENTS AND METHODS: Patients from 3 Ethics Review Board approved prospective studies of focal high intensity-focused ultrasound (HIFU) (Sonablate 500) for localized prostate cancer (T1c-T3a, Gleason grade≤4+3, and PSA≤20)...
September 20, 2016: Urologic Oncology
https://www.readbyqxmd.com/read/27613061/partial-prostatectomy-for-anterior-cancer-short-term-oncologic-and-functional-outcomes
#18
Arnauld Villers, Philippe Puech, Vincent Flamand, Georges-Pascal Haber, Mihir M Desai, Sebastien Crouzet, Xavier Leroy, Sameer Chopra, Laurent Lemaitre, Adil Ouzzane, Inderbir S Gill
BACKGROUND: Focal ablative therapy may be a suboptimal option for anterior prostate cancers (APCs) reaching the prostate apex due to concerns for thermal injury to the external sphincter. OBJECTIVE: To explore the technical feasibility of anterior partial prostatectomy (APP) for isolated APCs detected by magnetic resonance imaging (MRI), and to report short-term oncologic and functional outcomes. DESIGN, SETTING, AND PARTICIPANTS: Following institutional review board approval, over an 8-yr period (2008-2015) 17 consenting patients were enrolled in a prospective single-arm single-center Innovation, Development, Exploration, Assessment, Long-term (IDEAL) phase 2a study...
September 6, 2016: European Urology
https://www.readbyqxmd.com/read/27595377/new-and-established-technology-in-focal-ablation-of-the-prostate-a-systematic-review
#19
Massimo Valerio, Yannick Cerantola, Scott E Eggener, Herbert Lepor, Thomas J Polascik, Arnauld Villers, Mark Emberton
CONTEXT: Focal therapy of prostate cancer has been proposed as an alternative to whole-gland treatments. OBJECTIVE: To summarize the evidence regarding sources of energy employed in focal therapy. EVIDENCE ACQUISITION: Embase and Medline (PubMed) were searched from 1996 to October 31, 2015 following the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. Ongoing trials were selected from electronic registries. The stage of assessment of each source of energy was determined using the Idea, Development, Exploration, Assessment, Long-term study recommendations...
August 29, 2016: European Urology
https://www.readbyqxmd.com/read/27582608/magnetic-resonance-image-guided-focal-prostate-ablation
#20
REVIEW
Sherif G Nour
Prostate cancer is the most common cancer (other than skin cancer) in American men, with one in seven men being diagnosed with this disease during his lifetime. The estimated number of new prostate cancer cases in 2016 is 180,890. For the first time, imaging has become the center of the search for contained, intraglandular, small-volume, and unifocal disease, and an increasing number of academic institutions as well as private practices are implementing programs for prostate multiplanar magnetic resonance imaging (MRI) as parts of their routine offerings...
September 2016: Seminars in Interventional Radiology
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