Jim C. Hu, MD, MPH

Jim C. Hu, MD, MPH, Director of the LeFrak Center for Robotic Surgery and the Ronald P. Lynch Chair in Urologic Oncology at Weill Cornell Medical College, reviews emerging data on patient selection and outcomes of focal therapy. He discusses results of recent studies examining high-intensity focused ultrasound (HIFU) and comparing it with cryoablation, and looks at cancer recurrence rates after focal therapy. Dr. Hu describes an exploratory study of in-office partial gland cryoablation, then discusses a current project, PC CONCEPT, which is evaluating focal therapy at a population level. He emphasizes that a significant number of men do not get a prostate biopsy during follow-up. Since 30-60% of men who do receive a follow-up biopsy are shown to have biopsy-proven cancer, there is concern that men who do not receive a biopsy at some point following treatment may have recurrent cancer and have missed a window of curability. Dr. Hu concludes by noting that functional outcome preservation is better with focal therapy than radical prostatectomy, with only a 1-2% risk of significant deterioration of urinary and sexual functioning. He also adds that volume and orientation changes after focal therapy can create significant challenges for accurate biopsy and surveillance.