Histopathologic basis for focal therapy in localized prostate cancer

Histopathologic basis for focal therapy (FT) in localized prostate cancer concerns: cancer significance (volume and grade) knowledge as a decision criteria for targeting treatment. Cancers more than 0.5 cm(3) of volume or more than 0.2 cm(3) and containing grade 4/5 are clinically significant and require treatment that can be FT. Secondary insignificant cancers can be managed watchfully; multifocality, spatial distribution and extent: 58% of cancers are multifocal and one fifth involves only one lobe. About two third of cancers are located in the inferior half of the gland. At a volume of 2 cm(3), craniocaudal spread of cancers extends to the whole lobe. These morphometric data are important for FT selecting patients. About a half of low D'Amico's risk cancers in recent radical prostatectomy series may be eligible for FT.