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University of Lynchburg DMSc Doctoral Project Assignment Repository

University of Lynchburg DMSc Doctoral Project Assignment Repository

Specialty

Urology

Advisor

Dr. Tom Colletti

Abstract

The purpose of this paper is to present a perspective on the current status and future directions of focal therapy (FT) as a primary treatment option for prostate cancer (PCa).

FT for localized PCa is a rapidly evolving field. Various recent concepts – the index lesion driving prognosis, the enhanced detection of clinically-significant cancer using multi-parametric magnetic resonance imaging (mpMRI) and targeted biopsy, improved risk-stratification using novel blood/tissue biomarkers, the recognition that reducing radical treatment (RT)-related morbidity (along with reducing pathologic progression) as a clinically meaningful endpoint - have all led to a growing interest in FT. Novel FT modalities are being investigated, mostly in phase I and II studies. Recently, level I prospective randomized data comparing partial gland ablation to standard-of-care treatment became available from one study by Azzouzi, et al1. In addition, recent developments in imaging, including 7-Tesla mpMRI, functional imaging, radiomics and contrast-enhanced ultrasound show early promise. The author also discusses emerging concepts and expanding indications in patient selection for FT.

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