Background: Focal therapy is a promising, minimally invasive method for the treatment of patients with localized prostate cancer. According to the existing literature, there is growing evidence for positive functional outcomes and oncological effectiveness. The aim of this review is to evaluate the technical efficacy of three minimally invasive techniques (cryoablation, electroporation, and microwave ablation) and their impact on quality of life in patients with prostate cancer. Methods: Studies between January 2020 and July 2023 were selected using PubMed, Embase, and The Cochrane Library and analyzed following PRISMA guidelines; they have not been registered. Results: Twenty-three studies investigating three different sources of energy to deliver focal therapy were found. Thirteen studies evaluated the performance of the cryoablation therapy, seven studies of the irreversible electroporation, and three studies of microwave ablation option. The majority of studies were retrospective cohort studies. Cryoablation showed excellent oncological outcomes for low-grade prostate cancer, whether performed on the lesion, on the hemigland, or on the entire gland, with the best results obtained for patients with intermediate risk. Irreversible electroporation showed promising oncological outcomes with no significant changes in functional outcomes. Microwave ablation showed great early functional outcomes. Conclusions: The oncological effectiveness of minimally invasive treatment in comparison to standard of care is still under investigation, despite encouraging results in terms of functional outcomes improvement and adverse events reduction. More comprehensive research is needed to fully understand the function of minimally invasive treatment in patients with localized PCa.
背景：局部治疗是一种有前景的微创方法，用于治疗局限性前列腺癌患者。根据现有文献，越来越多的证据表明其在功能结果和肿瘤学有效性方面具有积极效果。本综述旨在评估三种微创技术（冷冻消融、电穿孔和微波消融）的技术疗效及其对前列腺癌患者生活质量的影响。方法：通过PubMed、Embase和Cochrane图书馆筛选2020年1月至2023年7月期间的研究，并遵循PRISMA指南进行分析；这些研究尚未注册。结果：共发现23项研究探讨了三种不同能量来源的局部治疗方法。其中13项研究评估了冷冻消融疗法的效果，7项研究评估了不可逆电穿孔疗法，3项研究评估了微波消融疗法。大多数研究为回顾性队列研究。冷冻消融在低级别前列腺癌中显示出优异的肿瘤学结果，无论是针对病灶、半腺体还是整个腺体进行治疗，其中中危患者的效果最佳。不可逆电穿孔显示出有前景的肿瘤学结果，且功能结果无明显变化。微波消融在早期功能结果方面表现出色。结论：尽管微创治疗在改善功能结果和减少不良事件方面取得了令人鼓舞的成果，但其与标准治疗相比的肿瘤学有效性仍在研究中。需要更全面的研究来充分理解微创治疗在局限性前列腺癌患者中的作用。
肿瘤(癌症)患者之家