Robotic‐assisted laparoscopic radical prostatectomy for treatment of a newly identified lesion revealed no viable cells in the previously treated area with microwave focal therapy

• Published in: IJU case reports Vol. 7; no. 4; pp. 313 - 315
• Main Authors: Tsukuda, Fumio, Shimizu, Toshihiro, Hagiwara, Kiichi, Kawano, Yoshiyuki, Sakamoto, Noboru, Itagaki, Shingo, Horiguchi, Yutaka, Koga, Shoji, Ukimura, Osamu
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons, Inc 01.07.2024; John Wiley and Sons Inc; Wiley
• Subjects: Ablation; Biopsy; Case Report; Case reports; Clinical trials; Conflicts of interest; Editing; Laparoscopy; Magnetic resonance imaging; microwave focal therapy; mpMRI; MR/US fusion‐guided targeted biopsy; Necrosis; Patients; Prostate cancer; RARP; Ultrasonic imaging; Writing; United States > US; Japan; prostate cancer; microwave focal therapy; RARP; MR/US fusion‐guided targeted biopsy; mpMRI
• ISSN: 2577-171X; 2577-171X
• DOI: 10.1002/iju5.12733

Introduction Histological outcome of the targeted focal therapy is in principle confirmed by targeted needle biopsy from the treated area in clinical trial. Herein, we report a rare case in which the MFT was followed by RARP. Case presentation A 68‐year‐old man with PSA 9.6 ng/mL and PI‐RADS 4 lesion in the right transition zone on multi‐parametric MRI underwent MR/ultrasound fusion‐guided targeted biopsy, which revealed grade‐group 1 cancer. Targeted focal therapy with microwave ablation was performed, resulting in disappearance of the PI‐RADS 4 lesion at post‐operative 4 months. However, PSA rose to 11.5 ng/mL, and a new PI‐RADS 4 lesion, was identified in the left peripheral zone. RARP was performed to reveal new grade‐group 3 cancer, and no viable cells in the previously treated area with MFT. Conclusion RARP was safely performed even after MFT and proved the pathological complete response of microwave ablation.