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Table 1 Ideal Candidates for Focal Therapy*

From: Focal therapy for prostate cancer: revolution or evolution?

Serum PSA

PSA < 10 ng/mL, PSAD < 0.15 ng/mL/g

Clinical Stage

T1NxMx or T2aNxMx

Pathologic evaluation/Gleason score^

3+3 or less (no grade 4 or 5)

 

No more than 2 adjacent regions positive for cancer

 

Total length of cancer < 10 mm total and < 7 mm in any 1 core; < 1/3 of cores positive for cancer

Radiologic Imaging (MRI +/- MRSI)

Largest dimension < 15 mm if prostate volume > 25 grams or < 10 mm if volume < 25 grams. Capsular contact < 5 mm on axial imaging. No signs of extracapsular extension or seminal vesicle invasion

  1. * adapted from Sartor, 2008.
  2. ^10 core minimum biopsy schema, plus 2 additional cores for every 10 grams of prostate > 40 grams (max of 18 cores)