Evidence map›Paper›PMID 39418491›Full record

ReviewCanadian Urological Association journal = Journal de l'Association des urologues du Canada2025

The use of focal therapy for the treatment of prostate cancer in Canada Where are we, how did we get here, and where are we going?

Ravi Kumar, Sangeet Ghai, Antonio Finelli, Laurence Klotz, Adam Kinnaird, Miles Mannas, Bimal Bhindi, Rafael Sanchez-Salas, Maurice Anidjar, Ardalanejaz Ahmad and 3 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Ravi KumarDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Sangeet GhaiDepartment of Medical Imaging, University of Toronto, Toronto, ON, Canada.
Antonio FinelliDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Laurence KlotzDepartment of Surgery, University of Toronto, Toronto, ON, Canada.
Adam KinnairdDepartment of Surgery, University of Alberta, Edmonton, AB, Canada.
Miles MannasDepartment of Urologic Sciences, University of British Columbia, Vancouver, BC, Canada.
Bimal BhindiDepartment of Surgery, University of Calgary, Calgary, AB, Canada.
Rafael Sanchez-SalasDepartment of Surgery, McGill University, Montreal, QC, Canada.
Maurice AnidjarDepartment of Surgery, McGill University, Montreal, QC, Canada.
Ardalanejaz AhmadDepartment of Surgery, University of Manitoba, Winnipeg, MB, Canada.
Joseph ChinDepartment of Surgery, University of Western Ontario, London, ON, Canada.
Brant InmanDepartment of Surgery, University of Western Ontario, London, ON, Canada.
Nathan PerlisDepartment of Surgery, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionFocal therapy is an emerging treatment for localized prostate cancer (PCa). The objectives of this review were to: 1) review how focal therapies are regulated and approved; 2) summarize the scope and quality of the literature regarding safety, efficacy, and side-effects; and 3) outline ongoing clinical trials of focal therapy in Canada.

methodsUsing the PRISMA framework for scoping reviews, we searched PubMed, Embase, and Cochrane from 2021-2024, complementing Hopstaken et al's search up to 2020. We focused on studies reporting functional and oncologic outcomes. Additionally, we examined the FDA database for regulatory details and ongoing trials in Canada via ClinicalTrials.gov.

resultsFDA approval for prostate tissue ablation was granted to high-intensity focused ultrasound (HIFU) in 2015 via the de novo pathway; other therapies followed the 510(k) route, citing equivalence to predicate devices. Most studies are in early stages, primarily single-arm, prospective cohort designs. Oncologic outcomes like cancer detection and survival rates, alongside functional data, such as adverse events and erectile function, were assessed. Recurrence-free survival at 48 months ranged from 58-92%, pad-free rates were greater than 95%, and rates of new-onset erectile dysfunction were variable, ranging from no change to 50%. Rates of serious adverse events were low, ranging from 0-14%. Three Canadian clinical trials are actively enrolling participants, and five private clinics were found offering private HIFU, irreversible electroporation, or transurethral ultrasound ablation.

conclusionsFocal therapy technologies have gained regulatory approval for prostate tissue ablation, and aside from provincial support for cryoablation in Alberta, are available to Canadians through private payment or clinical trials. Many studies demonstrate promising cancer control and impressive functional outcomes but are limited by their short followup and lack of comparator group. Clinical trial or registry participation should be prioritized to ensure an evidence-based integration into current prostate cancer treatment approaches.

Identifiers

PMID39418491
PMCPMC11819858

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.