A systematic review of outcomes after thermal and nonthermal partial prostate ablation Review


Authors: Fainberg, J. S.; Al Hussein Al Awamlh, B.; DeRosa, A. P.; Chesnut, G. T.; Coleman, J. A.; Lee, T.; Ehdaie, B.
Review Title: A systematic review of outcomes after thermal and nonthermal partial prostate ablation
Abstract: We sought to compare oncologic and functional outcomes between thermal and nonthermal energy partial gland ablation (PGA) modalities. We conducted comprehensive, structured literature searches, and 39 papers, abstracts, and presentations met the inclusion criteria of pre-PGA magnetic resonance imaging, oncologic outcomes of at least 6 months, and systematic biopsies after PGA. Twenty-six studies used thermal ablation: high-intensity focused ultrasound (HIFU), cryotherapy, focal laser ablation, or radiofrequency ablation. In-field recurrence rates ranged from 0 to 36% for HIFU, 6 to 24% for cryotherapy, 4 to 50% for focal laser ablation, and 20 to 25% for radiofrequency ablation. Twelve studies used nonthermal technologies of focal brachytherapy, vascular-targeted photodynamic therapy, or irreversible electroporation. Focal brachytherapy had the lowest reported failure rate of 8%, vascular-targeted photodynamic therapy had >30% positive in-field biopsies, and irreversible electroporation had in-field recurrence rates of 12–35%. PGA was well tolerated, and nearly all patients returned to baseline urinary function 12 months later. Most modalities caused transient decreases in erectile function. Persistent erectile dysfunction was highest in patients who underwent HIFU. Although oncologic outcomes vary between treatment modalities, systematic review of existing data demonstrates that PGA is a safe treatment option for patients with localized prostate cancer. © 2021
Keywords: prostate cancer; focal therapy; thermal; partial gland ablation; non-thermal
Journal Title: Prostate International
Volume: 9
Issue: 4
ISSN: 2287-8882
Publisher: Elsevier BV  
Date Published: 2021-12-01
Start Page: 169
End Page: 175
Language: English
DOI: 10.1016/j.prnil.2021.04.001
PROVIDER: scopus
PMCID: PMC8740376
PUBMED: 35059352
DOI/URL:
Notes: Review -- Export Date: 1 February 2022 -- Source: Scopus
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  1. Jonathan Coleman
    343 Coleman
  2. Behfar Ehdaie
    174 Ehdaie
  3. Gregory Thomas Chesnut
    19 Chesnut
  4. Taehyoung Lee
    7 Lee