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Erschienen in: International Journal of Clinical Oncology 4/2020

10.02.2020 | Invited Review Article

Current status and future prospective of focal therapy for localized prostate cancer: development of multiparametric MRI, MRI-TRUS fusion image-guided biopsy, and treatment modalities

verfasst von: Sunao Shoji, Shinichiro Hiraiwa, Izumi Hanada, Hakushi Kim, Masahiro Nitta, Masanori Hasegawa, Yoshiaki Kawamura, Kazunobu Hashida, Takuma Tajiri, Akira Miyajima

Erschienen in: International Journal of Clinical Oncology | Ausgabe 4/2020

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Abstract

Multiparametric magnetic resonance imaging (mpMRI) has been increasingly used to diagnose clinically significant prostate cancer (csPC) because of its usefulness in combination with anatomic and functional data. MRI-targeted biopsy, such as MRI-transrectal ultrasound (TRUS) fusion image-guided prostate biopsy, has high accuracy in the detection and localization of csPC. This novel diagnostic technique contributes to the development of tailor-made medicine as focal therapy, which cures the csPC while preserving the anatomical structures related to urinary and sexual function. In the early days of focal therapy, TRUS-guided systematic biopsy was used for patient selection, and treatment was performed for patients with low-risk PC. With the introduction of mpMRI and mapping biopsy, the treatment range is now determined based on individualized cancer localization. In recent prospective studies, 87.4% of treated patients had intermediate- and high-risk PC. However, focal therapy has two main limitations. First, a randomized controlled trial would be difficult to design because of the differences in pathological features between patients undergoing focal therapy and radical treatment. Therefore, pair-matched studies and/or historical controlled studies have been performed to compare focal therapy and radical treatment. Second, no long-term (≥ 10-year) follow-up study has been performed. However, recent prospective studies have encouraged the use of focal therapy as a treatment strategy for localized PC because it contributes to high preservation of continence and erectile function.
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Metadaten
Titel
Current status and future prospective of focal therapy for localized prostate cancer: development of multiparametric MRI, MRI-TRUS fusion image-guided biopsy, and treatment modalities
verfasst von
Sunao Shoji
Shinichiro Hiraiwa
Izumi Hanada
Hakushi Kim
Masahiro Nitta
Masanori Hasegawa
Yoshiaki Kawamura
Kazunobu Hashida
Takuma Tajiri
Akira Miyajima
Publikationsdatum
10.02.2020
Verlag
Springer Singapore
Erschienen in
International Journal of Clinical Oncology / Ausgabe 4/2020
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-020-01627-8

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