Focal therapy (FT) became a frequently discussed treatment strategy of localized prostate cancer (PCa), but the acceptance and evaluation of FT by practicing urologists is still unclear.
A 25-item anonymized online questionnaire (SurveyMonkey®) was compiled by the German Society of Residents in Urology (GesRU) Academics prostate cancer working group and sent to the members of the German association of Urology (DGU). Logistic regression analysis was performed to determine parameters for suggestion FT.
210 urologists (median age 49 years) participated, from which 72% stated PCa as their main treatment focus. 99% of urologists were aware of and 54% wanted to improve their knowledge about FT. 65% do not treat PCa with FT. FT is seen as an alternative to active surveillance and radiotherapy/radical prostatectomy by 66% and 37%, respectively. Regarding to FT treatment strategies, 35% and 45% would treat all or all significant PCa foci, respectively, whereas 19% would treat mainly the index foci. Currently, 27% believe that FT will be an option as standard treatment in future, but 48% would not suggest FT to their patients, due to a lack of evidence and insufficient diagnostic tools proper patient selection today. Suggesting FT to patients is associated with self-performing FT (odds ratio [OR] 2.88, 95% confidential interval [CI] 1.31-6.31) and believing in FT as a standard treatment in future (OR 9.05, 95% CI 6.68-22.30) (both p<0.01).
FT has currently no wide acceptance in German practicing urologists mainly due to the lack of evidence of FT superiority as compared to standard treatments.
Journal of endourology. 2020 Sep 16 [Epub ahead of print]
Mike Wenzel, Hendrik Borgmann, Jost Von Hardenberg, Hannes Cash, Maria Noemi Welte, Johannes Bruendl, Manuela A Hoffmann, Thomas Höfner, Angelika Borkowetz
Department of Urology, University Hospital Frankfurt, Frankfurt, Germany, Frankfurt, Germany; ., Department of Urology, University Hospital Mainz, Mainz, Germany, Mainz, Germany; ., Department of Urology and Urosurgery, University Medical Centre Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; ., Charite Universitatsmedizin Berlin, 14903, Department of Urology, Hindenburgdamm 30, Berlin, Germany, 12200; ., Department of Urology, University Hospital Frankfurt, Frankfurt, Germany, Frankfurt, Germany; ., Department of Urology, University Hospital Regensburg, Regensburg, Germany, Regensburg, Germany; ., Department of Occupational Health and Safety, Federal Ministry of Defense, Bonn, Germany, Bonn, Germany., Department of Urology, University Hospital Mainz, Mainz, Germany, Mainz, Germany; ., Department of Urology, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany, Dresden, Germany; .