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Abstract

We agree with the reviewer that if we were evaluating biopsy characteristics to select ideal candidates for focal therapy we would include only patients with unilateral cancer on biopsy and with low-volume (Damico), low-risk features. This, however, was not the purpose of our report. Rather, our goal was to identify, from an existing population of radical prostatectomy patients, which men would have been ideal candidates for focal therapy. Although evaluating biopsy information could theoretically provide this same information, our data would suggest otherwise. The analysis of our database showed that even in men with unilateral (Damico low-risk), low-volume prostate cancer, only 25% had true unilateral disease on the pathologic radical prostatectomy specimen. Editorial CommentUrologyVol. 73Issue 2PreviewThe study by Taneja et al. examines in a contemporary cohort of men undergoing radical prostatectomy the likelihood of the presence of unilateral disease as a surrogate marker for the incidence of men suitable for focal therapy. They found that only 21.3% had unilateral cancer, concluding that only a small minority of men would be candidates for focal therapy. What is not provided are detailed characteristics of these men's tumor on biopsy and the tumor volume and grade of the bilateral tumor. Candidates for focal therapy should have unilateral cancer on biopsy that is not high grade and not high volume. Full-Text PDF Appropriate Candidates for Hemiablative Focal Therapy Are Infrequently Encountered Among Men Selected for Radical Prostatectomy in Contemporary CohortUrologyVol. 73Issue 2PreviewTo assess the prevalence and pathologic features of men with unilateral prostate cancer at radical prostatectomy (RP), because it has recently been proposed that men with small-volume, well-differentiated, unilateral prostate cancer can be treated with focal therapy. Full-Text PDF