Salvage Local Treatments After Focal Therapy for Prostate Cancer.

Détails

ID Serval
serval:BIB_1014465520F4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Salvage Local Treatments After Focal Therapy for Prostate Cancer.
Périodique
European urology oncology
Auteur(s)
Marra G. (co-premier), Valerio M. (co-premier), Emberton M., Heidenreich A., Crook J.M., Bossi A., Pisters L.L.
ISSN
2588-9311 (Electronic)
ISSN-L
2588-9311
Statut éditorial
Publié
Date de publication
09/2019
Peer-reviewed
Oui
Volume
2
Numéro
5
Pages
526-538
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
Whether focal therapy (FT) for prostate cancer (PC) jeopardizes outcomes from salvage treatments is a matter of debate still to be resolved.
To review the literature on oncological and functional outcomes and complications for available treatment options for recurrent or residual PC after primary FT.
We performed a nonsystematic search of PubMed for articles assessing relevant outcomes for salvage local treatment after FT failure using a manual search. When no evidence could be extracted for the FT domain, records dealing with recurrence after whole-gland ablation were considered.
Four retrospective series assessed salvage treatments after FT failure evaluating cases of radical prostatectomy (RP) and repeat ablation (sample size from 12 to 22 patients). The quality of the studies was low, with a high risk of bias. Other options are radiation therapy (RT) and whole-gland or focal repeat ablations, although these have only been described after whole-gland ablation. With some exceptions, including sexual function for RP, overall complications and oncological and functional outcomes do seem to be acceptable and are not much worse than those in the primary setting. Important limitations include the low level of the evidence and the absence of standardized criteria for FT, salvage treatment, and FT failure.
Current evidence shows acceptable outcomes for post-FT salvage options, although this is based on retrospective data. While it seems that FT has a minimal impact on salvage treatment results, prospective controlled studies are needed to confirm these preliminary data.
We performed a literature search to determine the treatment options available for prostate cancer after failure of focal therapy and their outcomes. Options include radical prostatectomy, repeat whole-gland ablation, focal ablation, and radiotherapy. Overall cancer control, impacts on urinary and sexual function, and complications seem slightly worse but not markedly different compared to primary treatments, but high-quality studies are awaited to confirm these findings.
Mots-clé
Ablation Techniques/adverse effects, Ablation Techniques/methods, Disease Progression, Disease-Free Survival, Erectile Dysfunction/diagnosis, Erectile Dysfunction/epidemiology, Erectile Dysfunction/etiology, Humans, Lower Urinary Tract Symptoms/diagnosis, Lower Urinary Tract Symptoms/epidemiology, Lower Urinary Tract Symptoms/etiology, Male, Neoplasm Recurrence, Local/mortality, Neoplasm Recurrence, Local/pathology, Neoplasm Recurrence, Local/therapy, Neoplasm, Residual, Postoperative Complications/diagnosis, Postoperative Complications/epidemiology, Postoperative Complications/etiology, Prostate/pathology, Prostate/surgery, Prostatectomy/adverse effects, Prostatectomy/methods, Prostatic Neoplasms/mortality, Prostatic Neoplasms/pathology, Prostatic Neoplasms/therapy, Retreatment/adverse effects, Retreatment/methods, Salvage Therapy/adverse effects, Salvage Therapy/methods, Severity of Illness Index, Treatment Failure, Focal therapy, Prostate cancer, Radiotherapy, Recurrence, Salvage treatment, Surgery
Pubmed
Web of science
Open Access
Oui
Création de la notice
16/08/2019 16:54
Dernière modification de la notice
01/10/2020 5:25
Données d'usage