Société Internationale d'Urologie

Focal Therapy for Localized Prostate Cancer: Promise, Progress, and Unanswered Questions

- A special collection in *Prostate Cancer and Prostatic Diseases* provides a comprehensive assessment of focal therapy (FT) for localized prostate cancer, highlighting mature evidence and emerging technologies. - Pooled data from 49 cohorts show excellent short- to intermediate-term oncological outcomes for HIFU, cryotherapy, and IRE, with overall and cancer-specific survival rates approaching 99%. - Emerging modalities including MRI-guided focused ultrasound, TULSA, focal laser ablation, and histotripsy demonstrate encouraging efficacy with excellent functional preservation, though long-term data remain limited. - Key challenges persist around patient selection, imaging accuracy, standardized surveillance protocols, and the lack of prospective evidence comparing FT oncological efficacy against standard-of-care radical treatments.