Patient selection for hemiablative focal therapy of prostate cancer

Abstract

BACKGROUND: The application of focal therapy for low‐risk prostate cancer (PCa) depended on appropriate patient selection. No definitive criteria existed to characterize patients who may potentially benefit from an organ‐sparing approach. We evaluated pretreatment clinical parameters that may predict unilateral PCa amenable to hemigland thermoablation. METHODS: In total, 538 patients with complete data from the Duke Prostate Center (DPC) Outcomes database with low‐ to low‐intermediate–risk PCa (prostate‐specific antigenP < .0005) and negative family history of PCa (OR = 1.83; 95% CI, 1.09‐3.05; P = .21) was associated with a higher probability of unilateral disease by multivariate regression. CONCLUSIONS: Two pretreatment clinical variables were significantly predictive of unilateral PCa: negative family history of PCa and PBx unilaterality. These variables may be used to select men with low‐ to low‐moderate–risk PCa for hemiablation. Further work is necessary to decrease the false‐negative and false‐positive rates associated with PBx to improve predictability for PCa laterality. Cancer 2009. © 2009 American Cancer Society.