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Selecting Candidates for Focal Therapy

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Grand Rounds in Urology

Abhinav Sidana, MD, Assistant Professor of Surgery, Director of Urologic Oncology, and a urologic surgeon at the University of Cincinnati Medical Center in Ohio, discusses criteria for the selection of candidates for focal therapy, including imaging modalities for focal therapy screening, biopsy strategies to determine focal therapy candidacy, and optimal characteristics (of the cancer and the patient) for treatment. Dr. Sidana explains that prostate mpMRI should be followed by guided biopsy (and in the absence of mpMRI, a template mapping biopsy should occur), ideal cancers are unifocal or unilateral GleasonGrade (GG) 23, the goal should be to preserve at least one neurovascular bundle and avoid injury to the urethra and sphincter, and planned treatment should not spare any ≥GG2 cancer outside of the treatment zone.

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