FOCAL THERAPY VS. RADICAL PROSTATECTOMY WITH PHARMACOLOGICAL PROFILING: A CASE CONTROL TRIAL FOR LOCALIZED PROSTATE CANCER

Abstract

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.