Evidence map›Paper›PMID 42682046›Full record

ArticleThe Canadian journal of urology2026

Pathologic failure and salvage approaches following focal therapy for localized prostate cancer.

Samuel Tremblay, Seyed Sajjad Tabei, Shima Tayebi, Benjamin H Hinrichs, Alon Lazarovich, Jason Koehler, Wei-Wen Hsu, Sadhna Verma, Abhinav Sidana

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Article in The Canadian journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Samuel Tremblay *Section of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
Seyed Sajjad Tabei *Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
Shima TayebiDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Benjamin H HinrichsDepartment of Pathology & Laboratory Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Alon LazarovichSection of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.
Jason KoehlerDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Wei-Wen HsuDivision of Biostatistics & Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Sadhna VermaDepartment of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
Abhinav SidanaSection of Urology, Department of Surgery, University of Chicago, Chicago, IL, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFocal therapy (FT) is an emerging treatment modality for localized prostate cancer. However, limited data are available regarding the patterns of oncologic failure post-FT. This study aims to characterize the features of oncologic failure and salvage strategies following FT.

methodsPatients presenting with pathologic failure (PF) after receiving FT (cryotherapy, High-intensity focused ultrasound, or irreversible electroporation) for intermediate-risk prostate cancer were selected from a prospective registry between 2018 and 2023. All patients underwent protocol-based follow-up, including PSA testing, multiparametric MRI, and mandatory biopsy. The primary outcome was PF, defined as biopsy-confirmed Grade Group ≥2 cancer post-treatment. Failures were classified as in-field or out-of-field based on lesion location relative to the ablation zone.

resultsThis study included 101 patients who underwent primary FT, with a median follow-up of 16.5 months. PF occurred in 18 patients (17.8%). Failures included 7 in-field, 9 out-of-field, and 2 involving both locations. Notably, 50% of recurrences had no suspicious findings on MRI, and 67% occurred without meeting Phoenix PSA criteria for biochemical recurrence. Failures were typically low-volume (mean longest positive core length 4.8 mm), and 11 were detected within the first 12 months of follow-up. Among those with PF, definitive salvage treatments included repeat FT (55.6%), active surveillance (16.7%), radical prostatectomy (11.1%), whole-gland ablation (5.6%), and radiation therapy (11.1%).

conclusionsFocal therapy is increasingly used for localized prostate cancer, but many failures occur without PSA rise or imaging abnormalities. These findings suggest that although PSA testing and imaging are valuable for surveillance after FT, biopsy remains essential.

Indexed as

Neoplasm Recurrence, LocalProstatic NeoplasmsSalvage TherapyAgedCryotherapyHumansIrreversible Electroporation TherapyMaleMiddle AgedProspective StudiesProstate-Specific AntigenTreatment FailureProstate-Specific Antigencryotherapyfocal therapyhigh-intensity focused ultrasoundirreversible electroporationlocal recurrenceProstate cancer

Identifiers

PMID42682046

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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.