Table 3. List of studies assessing FT standardization.
| Author (ref) | Year | Aspect investigated | Key findings | Key recommendations |
|---|---|---|---|---|
| Postema et al. (27) | 2016 | To reach standardized terminology in FT for PCa | FT is a rapidly evolving field of prostate cancer treatments that intends to prevent or delay whole gland treatment associated morbidity without compromising oncologic safety | For the development and implementation of FT, it is important to have standardized reporting criteria. |
| Lebastchi et al. (28) | 2020 | To reach standardized terminology and follow-up in FT for PCa | The specific term “Focal Therapy” must be meant to describe guided ablation of an image-defined, biopsy confirmed, cancerous lesion(s) with a safety margin surrounding the target lesion | The panel recommends the use of standardized nomenclature and follow-up protocols to generate reliable data |
| Espinós et al. (29) | 2016 | Evaluating what type of energy would be the optimal for FT | Lesion localization, technical characteristics of each type of energy, patient`s profile and secondary effects must be considered in every choice of focal therapy | The authors propose the “á la carte” model, based on localization of the lesion |
| Stabile et al. (30) | 2021 | To assess whether PCa location might affect oncologic outcomes after FT | The PCa location does not significantly affect the rate of failure after FT. Both HIFU and cryotherapy likely achieve similar medium-term oncologic results regardless of PCa location even though cryotherapy might be preferable for patients with apical disease | Cryotherapy might be preferable for patients with apical disease. The presence of an apical lesion should not be considered an exclusion criteria for FT |
| Muller et al. (31) | 2015 | International multidisciplinary consensus for follow-up after FT | Large heterogeneity within current studies with regards to follow-up after FT. It is important to standardize to allow for comparability and safe adoption | The follow-up after focal therapy should be a minimum of 5 years. A mpMRI systematic 12-core biopsy combined with 4–6 targeted biopsy cores of the treated area and any suspicious lesion(s) should be performed after 1 year, and thereafter only when there is suspicion on imaging. PSA should be performed, in the first year, every 3 months, and after the first year, every 6 months. Imaging should be performed at 6 months and at 1 year following treatment. After the first year post-treatment, it should be performed every year until 5 years following treatment |
| Dickinson et al. (32) | 2017 | To assess the diagnostic performance of PSA parameters and MRI compared to histological outcomes following FT | Early and late MRI performed better than PSA measurements in the detection of residual tumor after focal therapy. MRI, in the form of early and later mpMRI, strongly predicts a negative biopsy after focal therapy for localized PCa | In the context of FT Follow-up, PSA parameters are less reliable than mpMRI |
FT, focal therapy; HIFU, High intensity focused ultrasound; mpMRI, multiparametric magnetic resonance imaging; PCa, prostate cancer; PSA, prostate-specific antigen.