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Abstract Introduction Although focal therapy as a definite treatment modality for prostate cancer patients has been increasing in the United States, there has been paucity of patient reported outcome measures (PROM) specific to urinary, erectile, and sexual function Objective We aim to evaluate the long-term PROM in men undergone focal therapy for prostate cancer since 2019. Methods Web search was performed on the PubMed database. The search was limited to articles published in the English language and reporting focal therapy outcomes between 2019 and 2023, including randomized controlled trials, prospective and retrospective studies. The following data were extracted from each study: year, type of focal therapy, design, participants, demographic, IIEF, ED proportion, IPSS, EPIC, pad incontinence use, fistula rate, urinary retention rate, hematuria, Gleason scores, time to oncologic follow-up, recurrence, and presence of cancer after treatment. Results Twenty-three studies, consisting of cryotherapy, HIFU, TULSA, focal and microwave ablation where met the inclusion criteria and reviewed. Oncologic outcomes were reported in 17 of 23 studies. Median follow-up ranged from 3 to 42 months. Main oncologic outcomes analyzed were in-field/out-of-field recurrence and presence of prostate cancer after treatment. The two largest HIFU studies (n=90, n=101) had 9% and 24% respectively for clinically significant recurrence. The two focal microwave ablation studies (n=55, n=5) had 9% and 20% recurrence rates respectively. Functional outcomes were assessed by IPSS and IIEF. IPSS scores were consistent, with most studies reporting only minimal changes in IPSS after treatment. IIEF scores were generally consistent before and 6 months after procedure for all studies, with some reporting only marginal declines in erectile function. Complication rates among studies were low. Nine studies reported UTI rates ranging from 0% (n=6, n=41) to 30% (n=10) in a TULSA prospective study. Urinary retention rates were reported in 14 studies, with a range from 0% (n=41) to 30% (n=10). Conclusions This review suggests that focal therapies remain safe and effective treatment modality for patients with low-intermediate risk prostate cancer. PROM pertaining to urinary and erectile functions in men undergone focal therapy modality seems to be adequate without worse oncological or complication outcomes. Larger data with oncological and functional outcomes is warranted to further validate its safety and efficacy over longer follow up period. Disclosure No.
Raheem et al. (Fri,) studied this question.