Table 1.
Target population with stage of evaluation and level of evidence of 25 studies using focal therapy in the primary setting
| Eligibility criteria |
|||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference | Setting | IDEAL stage of evaluation | Previous treatment | Patients, no. | Age, yr | Preoperative biopsy | Preoperative imaging | Criteria for bDFS | Spatial location | PSA, ng/ml | Gleason score | Risk classification (D’Amico or NCCN) | Level of evidence |
| Madersbacher et al. [15] | Primary | 1 | NR | 29 | Mean: 64 (SD: 7.2) | NR | NR | NR | Unilateral | NR | NR | NR | 2c |
| Zlotta et al. [16] | Primary | 1 | NR | 15 | NR | NR | NR | NR | Organ confined | NR | NR | NR | 2c |
| Beerlage et al. [17] | Primary | 1 | NR | 14 | Mean: 62 (range: 55–69) | TRUS biopsy | MRI Bone scan |
NR | NR | NR | NR | NR |
2c |
| Souchon et al. [18] | Primary | 1 | NR | 2 | NR | NR | MRI | NR | Organ confined | NR | NR | NR | 2c |
| Moore et al. [19] | Primary | 1 | No | 6 | Median: 66 (range: 61–71) | TRUS biopsy | MRI Bone scan |
NR | Organ confined | ≤15 | ≤3 + 3 | NR | 2c |
| Bahn et al. [20] | Primary | 2a | NR | 31 | Mean: 63 (range or SD: NR) | TRUS sextant biopsy plus target biopsy of suspicious areas | TRUS Doppler evaluation | ASTRO | Unilateral | NR | NR | NR | 4 |
| Onik et al. [21] | Primary | 2a | 25 (45%) received short-term ADT (stopped at treatment) | 55 | NR | TRUS 10-core biopsy or transperineal template biopsy | NR | ASTRO | NR | NR | NR | NR | 4 |
| Ellis et al. [22] | Primary | 2a | NR | 60 | Mean: 69 (SD: 7.8) | NR | NR | ASTRO | NR | NR | NR | NR | 4 |
| Muto et al. [23] | Primary | 2a | 7 (24.1%) received short-term ADT (stopped at treatment) | 29 | Median: 72 (range: 62–80) | TRUS >12-core biopsy | MRI | ASTRO | Unilateral | NR | NR | NR | 3b |
| Murat et al. [24] | Primary | 2a | NR | 56 | Mean: 65.6 (range or SD: NR) | NR | NR | Phoenix | Unilateral | NR | NR | Low-intermediate | 4 |
| Lindner et al. [25] | Primary | 1 | No | 12 | Median: 56.5 (range: 51–62) | TRUS 12-core biopsy | MRI | NR | Tumour located in 1 of 12 core biopsy sectors | <10 | ≤3 + 3 | Low | 2c |
| Lindner et al. [26] | Primary | 1 | NR | 4 | Median: 66 (range: 61–73) | NR | NR | NR | NR | NR | NR | NR | 4 |
| Raz et al. [27] | Primary | 1 | NR | 2 | 73 | NR | MRI | NR | NR | NR | NR | NR | 4 |
| Truesdale et al. [28] | Primary | 2b | No | 77 | Mean: 69.5 (SD: 6.7) | TRUS biopsy | CT Bone scan |
Phoenix | Unilateral | NR | NR | NR | 4 |
| El Fegoun et al. [29] | Primary | 2a | No | 12 | Mean: 70 (SD: 4.8) | NR | CT Bone scan |
Phoenix | Unilateral | ≤10 | ≤3 + 4 | Low-intermediate | 4 |
| Ahmed et al. [30] | Primary | 2a | No | 20 | Mean: 60.4 (SD: 5.4) |
Transperineal template biopsy | MRI | NR | Unilateral | ≤15 | ≤4 + 3 | Low-intermediate | 2b |
| Ward et al. [31] | Primary | 2b | NR | 1160 | Mean: 67.8 (SD: 7.8) | NR | NR | ASTRO | No restriction | No restriction | No restriction | No restriction | 4 |
| Tay et al. [32] | Primary | 1 | No | 9 | NR | NR | MRI | NR | NR | <10 | ≤3 + 3 | Low | 4 |
| Chopra et al. [33] | Primary | 1 | No | 8 | Mean: 60 (range: 49–70) | TRUS 12-core biopsy | MRI | NR | NR | ≤15 | ≤4 + 3 | Low-intermediate | 2c |
| Bahn et al. [34]* | Primary | 2b | 13 (18%) received short-term ADT (stopped at treatment) | 73 | Median: 64 (range: 47–79) |
TRUS sextant biopsy plus mapping target biopsy of suspicious areas | TRUS Doppler evaluation | NR | Unilateral | ≤20 | ≤4 + 3 | Low-intermediate | 4 |
| Ahmed et al. [35] | Primary | 2a | No | 41 | Median: 63 (range: 58–66) | Transperineal template biopsy | MRI | NR | Unilateral and bilateral | ≤15 | ≤4 + 3 | Low-intermediate | 2b |
| Dickinson et al. [36]* | Primary | 2a | No | 88 | Median: 64 (range: 48–75) | Transperineal template biopsy | MRI | Phoenix and Stuttgart | Unilateral and bilateral | <20 | ≤4 + 3 | Low-intermediate | 2b |
| Nguyen et al. [37] | Primary | 2b | No | 318 | NR | TRUS biopsy (sextant between 1997–2003, then 10–12 cores) | MRI | Phoenix (and Phoenix plus PSAV >0.75/yr) | No tumour beyond peripheral zone | < 15 | ≤3 + 4 | Low-intermediate | 4 |
| Napoli et al. [38] | Primary | 1 | No | 5 | Median: 65.4 (range: 50–75) | NR | MRI | NR | Unilateral and unifocal | NR | ≤4+ 3 | Low-intermediate | 2c |
| Barret et al. [39] | Primary | 2b | No | 106 | Mean: 66.5 (IQR: 61–73) | Transperineal template biopsy (97%) and TRUS 12-core biopsy (100%) | MRI | NR | Unilateral | <10 | ≤3 + 3 | Low | 4 |
bDFS = biochemical disease-free survival; PSA = prostate-specific antigen; NCCN = National Comprehensive Cancer Network; NR = not reported; SD = standard deviation; TRUS = transrectal ultrasound; MRI = magnetic resonance imaging; ASTRO = American Society for Therapeutic Radiology and Oncology; CT = computed tomography; ADT = androgen-deprivation therapy; PSAV = prostate-specific antigen velocity; IQR = interquartile range.
*
This series partially overlaps with one previously reported.