John F Ward1. 1. Department of Urology, The University of Texas, M D Anderson Cancer Center, PO Box 301439, Houston, TX 77230-1439, USA. jfward@mdanderson.org
Abstract
INTRODUCTION: Despite the enthusiasm for an organ preserving approach to prostate cancer treatment, studies that support the supposition that this approach will offer patients the "Trifecta" of prostate cancer therapy are lacking. METHODS: Review of published peer review literature using a combination of the terms "Focal", "Prostate Cancer", "Therapy", "Cryoablation", "HIFU", and "Clinical Trial". RESULTS: To date only three prospective clinical trials of subtotal prostate cryoablation and one of subtotal high-intensity focused ultrasound (HIFU) have been reported along with one retrospective review of patients treated in a subtotal manner with cryotherapy. In total, these reports present only 166 patients. All current strategies for focally ablative therapy for prostate cancer treatment have varied in their eligibility criteria and in the amount of tissue targeted for destruction and/or preservation. CONCLUSIONS: Very little is published on either the oncologic outcomes or quality-of-life outcomes following subtotal prostate ablation to justify its growing popularity with both patients and physicians. Significant research and clinical trials that examine patient selection, biopsy strategies, and ablative energies, along with oncologic efficacy and quality-of-life outcomes are needed. This article will review the current state of knowledge regarding subtotal prostate ablative strategies.
INTRODUCTION: Despite the enthusiasm for an organ preserving approach to prostate cancer treatment, studies that support the supposition that this approach will offer patients the "Trifecta" of prostate cancer therapy are lacking. METHODS: Review of published peer review literature using a combination of the terms "Focal", "Prostate Cancer", "Therapy", "Cryoablation", "HIFU", and "Clinical Trial". RESULTS: To date only three prospective clinical trials of subtotal prostate cryoablation and one of subtotal high-intensity focused ultrasound (HIFU) have been reported along with one retrospective review of patients treated in a subtotal manner with cryotherapy. In total, these reports present only 166 patients. All current strategies for focally ablative therapy for prostate cancer treatment have varied in their eligibility criteria and in the amount of tissue targeted for destruction and/or preservation. CONCLUSIONS: Very little is published on either the oncologic outcomes or quality-of-life outcomes following subtotal prostate ablation to justify its growing popularity with both patients and physicians. Significant research and clinical trials that examine patient selection, biopsy strategies, and ablative energies, along with oncologic efficacy and quality-of-life outcomes are needed. This article will review the current state of knowledge regarding subtotal prostate ablative strategies.
Authors: Ian Thompson; James Brantley Thrasher; Gunnar Aus; Arthur L Burnett; Edith D Canby-Hagino; Michael S Cookson; Anthony V D'Amico; Roger R Dmochowski; David T Eton; Jeffrey D Forman; S Larry Goldenberg; Javier Hernandez; Celestia S Higano; Stephen R Kraus; Judd W Moul; Catherine M Tangen Journal: J Urol Date: 2007-06 Impact factor: 7.450
Authors: Duke K Bahn; Paul Silverman; Fred Lee; Robert Badalament; Eric D Bahn; John C Rewcastle Journal: J Endourol Date: 2006-09 Impact factor: 2.942