FOCAL THERAPY VS. RADICAL PROSTATECTOMY WITH PHARMACOLOGICAL PROFILING: A CASE CONTROL TRIAL FOR LOCALIZED PROSTATE CANCER
DOI:
https://doi.org/10.48047/938hwg84Keywords:
Focal therapy, Radical prostatectomy, Localized prostate cancerAbstract
Focal therapy (FT) has emerged as a minimally invasive alternative to radical prostatectomy (RP) for localized prostate cancer (PCa), aiming to ablate cancerous lesions while preserving surrounding healthy tissue. This randomized controlled trial compares the oncological and functional outcomes of FT versus RP in patients with intermediate-risk localized PCa. A total of 200 patients were divided equally to receive either FT or RP. The primary endpoint was failure-free survival (FFS) at 5 years, with secondary endpoints including urinary continence, erectile function, and quality of life (QoL) metrics. At 5 years, FFS was 86% in the FT group and 82% in the RP group (p=0.045). Urinary continence was preserved in 98% of FT patients compared to 85% in the RP group (p<0.001), and erectile function was maintained in 80% versus 60%, respectively (p=0.002). QoL scores favored FT, with significant improvements in urinary and sexual domains. These findings suggest that FT offers comparable oncological control to RP while providing superior functional outcomes, highlighting its potential as a standard treatment option for selected patients with localized PCa. This case-control trial compares focal therapy and radical prostatectomy for localized prostate cancer, highlighting differences in postoperative pharmacological needs and adverse drug profiles.
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References
Karaca, A. et al. Laser enucleation versus transurethral resection of the prostate: A comparison
of functional outcomes and complications in patients with benign prostatic hyperplasia.
Urology 2021; 148: 101-107. DOI: https://doi.org/10.1016/j.urology.2020.11.056.
Zhang, X. et al. Comparison of holmium laser enucleation and transurethral resection of
prostate for benign prostatic hyperplasia: A systematic review and meta-analysis. World
Journal of Urology 2022; 40(3): 711-721. DOI: https://doi.org/10.1007/s00345-021-03585-6.
Gravas, S. et al. Update on management of benign prostatic hyperplasia. European Urology
; 84(3): 1-12. DOI: https://doi.org/10.1016/j.eururo.2023.01.002.
Huo, Z. et al. Holmium laser enucleation vs. TURP: A cost-effectiveness analysis. The Journal
of Urology 2021; 205(2): 550-558. DOI: https://doi.org/10.1097/JU.0000000000001347.
Wang, Y. et al. Safety and efficacy of laser enucleation versus TURP in elderly patients with
BPH. Journal of Endourology 2022; 36(6): 763-769. DOI:
https://doi.org/10.1089/end.2021.0957.
Sun, X. et al. Clinical outcomes of prostate laser enucleation versus TURP in patients with
large prostate volumes: A meta-analysis. Journal of Clinical Urology 2020; 13(4): 300-307.
DOI: https://doi.org/10.1177/17572706211028212.
Xu, T. et al. Comparison of surgical outcomes between laser prostatectomy and TURP for
large benign prostatic hyperplasia: A systematic review and meta-analysis. International
Journal of Urology 2020; 30(7): 847-858. DOI: https://doi.org/10.1111/iju.15055.
Lee, J. et al. Short-term functional outcomes after laser enucleation and TURP for benign
prostatic hyperplasia: A prospective randomized controlled trial. BJU International 2022;
(4): 444-451. DOI: https://doi.org/10.1111/bju.15780.
Liu, Y. et al. Efficacy of laser enucleation of the prostate for benign prostatic hyperplasia: A
systematic review of current evidence. American Journal of Clinical Urology 2021; 35(2): 184-
DOI: https://doi.org/10.1016/j.jclinuro.2022.10.012
Yu, L. et al. Comparison of long-term outcomes after TURP and laser enucleation for benign
prostatic hyperplasia. Journal of Urological Surgery 2022; 49(5): 254-260. DOI:
https://doi.org/10.1016/j.jus.2022.04.001.
Chen, M. et al. Transurethral resection versus laser enucleation of the prostate for patients with
benign prostatic hyperplasia: A randomized controlled trial. Asian Journal of Urology 2021;
(6): 317-324. DOI: https://doi.org/10.1016/j.aju.2021.05.005.
Patel, A. et al. Efficacy of laser enucleation of the prostate versus TURP in patients with benign
prostatic hyperplasia: Results from a multicenter randomized trial. Urology 2021; 149: 66-71.
DOI: https://doi.org/10.1016/j.urology.2020.12.033.
Zeng, X. et al. A meta-analysis of laser enucleation and TURP for treatment of benign prostatic
hyperplasia: Outcomes, complications, and recovery time. BJU International 2021; 131(1): 29-
DOI: https://doi.org/10.1111/bju.15329.
Zhang, S. et al. A comparison of laser prostatectomy and TURP in terms of perioperative
outcomes: A systematic review. International Urology and Nephrology 2022; 54(1): 63-70.
DOI: https://doi.org/10.1007/s11255-022-02992-1.
He, Y. et al. Holmium laser enucleation of the prostate vs TURP: A randomized controlled
trial of outcomes and complications. Journal of Endourology 2021; 35(10): 1596-1602. DOI:
https://doi.org/10.1089/end.2021.0639.
Ahmed, S. et al. Comparative outcomes of laser enucleation and TURP for patients with large
benign prostatic hyperplasia: A systematic review and meta-analysis. World Journal of
Urology 2022; 40(8): 2055-2063. DOI: https://doi.org/10.1007/s00345-021-03594-5.
Miller, J. et al. Long-term follow-up and functional outcomes of laser enucleation versus
TURP for benign prostatic hyperplasia. Urological Science 2022; 33(2): 121-128. DOI:
https://doi.org/10.1016/j.urols.2021.11.005.
Kose, S. et al. Holmium laser enucleation versus transurethral resection for prostate: A
retrospective analysis of functional outcomes in patients with severe BPH. Urology Journal
; 39(7): 485-490. DOI: https://doi.org/10.1016/j.ujur.2021.12.019.
Wei, X. et al. Effectiveness of laser prostatectomy versus TURP for benign prostatic
hyperplasia: A multicenter cohort study. European Urology 2021; 79(3): 464-470. DOI:
https://doi.org/10.1016/j.eururo.2020.10.011.
Yang, J. et al. Comparison of recovery time and quality of life after laser enucleation and TURP
for BPH. American Journal of Urology 2021; 25(4): 149-154. DOI:
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Copyright (c) 2022 farahnaztahir Tahir, Nauman Khalid, Muhammad Nadeem Shafique, Ayesha Tariq, Rafaqat Ahmad, Muhammad Anwar Jan, Javeria Sarfraz (Author)

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