Functional outcomes of partial prostate ablation and focal therapy: are we managing expectations of a bar set too high?

Overview

PURPOSE OF REVIEW: Prostate ablation treatments have long been utilized although a recent shift away from whole gland ablation has occurred in an effort to decrease side-effects. Interest in this form of focal treatment has developed following encouraging initial reports suggesting feasibility, safety and favorable quality of life. Data on functional outcomes and limitations are now accumulating that require careful interpretation for educating patients and providers on the realistic outcomes achievable with these approaches. RECENT FINDINGS: Published results of partial prostate ablation provide short-term outcomes using a variety of metrics to estimate treatment effects on identified cancerous regions of the prostate. Validations of these metrics in regard to intermediate and long-term oncologic outcomes are awaited. Functional results indicate short-term effects on urinary and sexual function are frequent although perhaps less severe than whole gland or conventional treatments. SUMMARY: Outcome measures from prostate ablation have served to partially address some patient short-term goals of treatment and to support the further development of these approaches. More specific data to understand the long-term outcomes, goals and expectations for functional recovery that may be specific to each treatment modality are needed.