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Histological outcomes after focal high‐intensity focused ultrasound and cryotherapy

Shah, TT; Kasivisvanathan, V; Jameson, C; Freeman, A; Emberton, M; Ahmed, HU; (2015) Histological outcomes after focal high‐intensity focused ultrasound and cryotherapy. World Journal of Urology , 33 (7) pp. 955-964. 10.1007/s00345-015-1561-0. Green open access

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Abstract

Introduction Focal therapy has increasingly become an accepted treatment option for patients with localised pros- tate cancer. Most follow-up protocols use a mixture of pro- tocol biopsies or “for cause” biopsies triggered by a rising PSA. In this paper, we discuss the histological outcomes from these biopsies and their use in guiding subsequent management and trial development. Methods We conducted a literature search and reviewed the post-treatment biopsy results from studies on focal HIFU and focal cryotherapy. We subsequently reviewed the results of three recently published consensus statements released discussing many of the issues concerning focal therapy. Results Research suggests that 1 in 5 of all post-treat- ment biopsies after focal therapy are positive. However, the majority of these seemed to be from the untreated por- tion of the gland or met criteria for clinically insignificant disease. The histological outcomes from focal therapy are promising and confirm its effectiveness in the short to medium term. Furthermore re-treatment is possible whilst maintaining a low-side-effect profile. Conclusion Debate is ongoing about the clinical signifi- cance of various levels of residual disease after focal ther- apy and the exact threshold at which to call failure within a patient who has had focal therapy.

Type: Article
Title: Histological outcomes after focal high‐intensity focused ultrasound and cryotherapy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00345-015-1561-0
Publisher version: http://dx.doi.org/10.1007/s00345-015-1561-0
Language: English
Additional information: Copyright © The Author(s) 2015. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Focal therapy; Prostate cancer; Minimally invasive therapy; High-intensity focussed ultrasound; HIFU; Cryotherapy; Histology; Pathology; Trial design
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: https://discovery.ucl.ac.uk/id/eprint/1468613
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