Standardized Nomenclature and Surveillance Methodologies After Focal Therapy and Partial Gland Ablation for Localized Prostate Cancer: An International Multidisciplinary Consensus.

Focal therapy (FT) and partial gland ablation (PGA) are quickly adopted by urologists and radiologists as an option for the management of localized prostate cancer.

To find consensus on a standardized nomenclature and to define a follow-up guideline after FT and PGA for localized prostate cancer in clinical practice.

A review of the literature identified controversial topics in the field of FT. Online questionnaires were distributed to experts during three rounds, with the goal to achieve consensus on debated topics. The consensus project was concluded with a face-to-face meeting in which final conclusions were formulated.

Controlled feedback of responses of previous rounds were summarized and returned to the participants allowing them to re-evaluate their decisions. The level of agreement to achieve consensus on a topic was set at 80%.

Sixty-five experts participated in this interdisciplinary consensus study (72% urologists; 28% radiologists). The experts propose the use of the herein standardized nomenclature for ablative procedures. After FT/PGA, the following tests should be performed to assess treatment outcomes: prostate-specific antigen (PSA), imaging, biopsies, and functional outcome assessment. Although not a reliable marker for treatment failure, PSA should be measured every 3 mo in the 1st year and every 6 mo thereafter. Magnetic resonance imaging is the preferred image modality and should be performed at 6 and 18 mo after treatment. A systematic 12-core transrectal ultrasound-guided biopsy combined with a targeted biopsy of the treated area should be performed 6-12 mo after treatment. Functional outcomes should be obtained 3-6 mo after treatment for the first time and until stability is attained.

The panel recommends the use of the proposed nomenclature and follow-up protocols to generate reliable data supporting a broader implementation of FT as a standard of care for select patients with localized prostate cancer.

In this report, we present expert opinion on the use of a standardized nomenclature, and surveillance methodologies after focal therapy and partial gland ablation for localized prostate cancer.

European urology. 2020 Jun 09 [Epub ahead of print]

Amir H Lebastchi, Arvin K George, Thomas J Polascik, Jonathan Coleman, Jean de la Rosette, Baris Turkbey, Bradford J Wood, Michael A Gorin, Abhinav Sidana, Sangeet Ghai, Kae Jack Tay, John F Ward, Rafael Sanchez-Salas, Berrend G Muller, Bernard Malavaud, Pierre Mozer, Sebastien Crouzet, Peter L Choyke, Osamu Ukimura, Ardeshir R Rastinehad, Peter A Pinto

Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA., University of Michigan, Department of Urology, Ann Arbor, MI, USA., Department of Surgery, Duke University Medical Center, Durham, NC, USA., Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA., Department of Urology, Istanbul Medipol University, Istanbul, Turkey., Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA., Center for Interventional Oncology, Clinical Center, NIH, Bethesda, MD, USA., The James Buchanan Brady Urologic Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Division of Urology, University of Cincinnati College of Medicine, Cincinnati, OH, USA., Joint Department of Medical Imaging, University Health Network-Mount Sinai Hospital-Women's College Hospital, University of Toronto, ON, Canada., Department of Urology, Singapore General Hospital, Singapore., Division of Surgery, M.D. Anderson Cancer Center, University of Texas, Houston, TX, USA., Department of Urology, Institut Mutualiste Montsouris, Paris, France., Department of Urology, AMC University Hospital, Amsterdam, The Netherlands., Toulouse Cancer Institute, Toulouse, France., Academic Department of Urology, AP-HP, Hopital Pitié-Salpétrière, Paris, France., Department of Urology, Edouard Herriot Hospital, Université de Lyon, Lyon, France., Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan., Department of Interventional Radiology, Mount Sinai Health System, New York, NY, USA., Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA. Electronic address: .

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