***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: PURPOSE Men with localized prostate cancer currently face a number of treatment options that treat the entire prostate . These can cause significant sexual and urinary side effects .  Focal therapy offers a novel strategy that targets the cancer rather than the prostate in an attempt to preserve tissue and function . MATERIAL S AND METHODS A prospect i ve , ethics committee approved trial was conducted to determine the side effects of focal therapy using high intensity focused ultrasound . Multiparametric magnetic resonance imaging ( T2-weighted , dynamic contrast enhanced , diffusion-weighted ) and template transperineal prostate mapping biopsies were used to identify unilateral disease . Genitourinary side effects and quality of life outcomes were assessed using vali date d question naires . Posttreatment biopsies were performed at 6 months and followup was completed to 12 months . RESULTS A total of 20 men underwent high intensity focused ultrasound hemiablation .  Mean age was 60.4 years ( SD 5.4 , range 50 to 70 ) with mean prostate specific antigen 7.3 ng/ml ( SD 2.8 , range 3.4 to 11.8 ) . Of the men 25 % had low risk and 75 % had intermediate risk cancer .  Return of erections sufficient for penetrative sex occurred in 95 % of men ( 19 of 20 ) . In addition , 90 % of men ( 18 of 20 ) were pad-free , leak-free continent while 95 % were pad-free . Mean prostate specific antigen decreased 80 % to 1.5 ng/ml ( SD 1.3 ) at 12 months . Of the men 89 % ( 17 of 19 , 1 refused biopsy ) had no histological evidence of any cancer , and none had histological evidence of high volume or Gleason 7 or greater cancer in the treated lobe . In addition , 89 % of men achieved the trifecta status of pad-free , leak-free continence , erections sufficient for intercourse and cancer control at 12 months . CONCLUSIONS Our results appear sufficiently promising to support the further evaluation of focal therapy as a strategy to decrease some of the harms and costs associated with st and ard whole gl and treatments Background : To evaluate the safety and clinical feasibility of focal irreversible electroporation ( IRE ) of the prostate . Methods : We assessed the toxicity profile and functional outcomes of consecutive patients undergoing focal IRE for localised prostate cancer in two centres . Eligibility was assessed by multi-parametric magnetic resonance imaging ( mpMRI ) and targeted and /or template biopsy . IRE was delivered under transrectal ultrasound guidance with two to six electrodes positioned transperineally within the cancer lesion . Complications were recorded and scored accordingly to the NCI Common Terminology Criteria for Adverse Events ; the functional outcome was physician reported in all patients with at least 6 months follow-up . A contrast-enhanced MRI 1 week after the procedure was carried out to assess treatment effect with a further mpMRI at 6 months to rule out evidence of residual visible cancer . Results : Overall , 34 patients with a mean age of 65 years ( s.d.=±6 ) and a median PSA of 6.1 ng ml−1 ( interquartile range (IQR)= 4.3–7.7 ) were included . Nine ( 26 % ) , 24 ( 71 % ) and 1 ( 3 % ) men had low , intermediate and high risk disease , respectively ( D’Amico criteria ) . After a median follow-up of 6 months ( range 1–24 ) , 12 grade 1 and 10 grade 2 complications occurred . No patient had grade > /= 3 complication . From a functional point of view , 100 % ( 24/24 ) patients were continent and potency was preserved in 95 % ( 19/20 ) men potent before treatment . The volume of ablation was a median 12 ml ( IQR=5.6–14.5 ml ) with the median PSA after 6 months of 3.4 ng ml−1 ( IQR=1.9–4.8 ng ml−1 ) . MpMRI showed suspicious residual disease in six patients , of whom four ( 17 % ) underwent another form of local treatment . Conclusions : Focal IRE  has a low toxicity profile with encouraging genito-urinary functional outcomes . Further prospect i ve development studies are needed to confirm the functional outcomes and to explore the oncological potential PURPOSE We ascertained the feasibility and safety of image guided targeted photothermal focal therapy for localized prostate cancer . MATERIAL S AND METHODS Twelve patients with biopsy proven low risk prostate cancer underwent interstitial photothermal ablation of the cancer . The area of interest was confirmed and targeted using magnetic resonance imaging . Three-dimensional ultrasound was used to guide a laser to the magnetic resonance to ultrasound fused area of interest . Target ablation was monitored using thermal sensors and real-time Definity contrast enhanced ultrasound . Followup was performed with a combination of magnetic resonance imaging and prostate biopsy . Vali date d quality of life question naires were used to assess the effect on voiding symptoms and erectile function , and adverse events were solicited and recorded . RESULTS Interstitial photothermal focal therapy was technically feasible to perform . Of the patients 75 % were discharged home free from catheter the same day with the remainder discharged home the following day . The treatment created an identifiable hypovascular defect which coincided with the targeted prostatic lesion . There were no perioperative complications and minimal morbidity . All patients who were potent before the procedure maintained potency after the procedure . Continence levels were not compromised . Based on multicore total prostate biopsy at 6 months 67 % of patients were free of tumor in the targeted area and 50 % were free of disease . CONCLUSIONS Image guided focal photothermal ablation of low risk and low volume prostate cancer is feasible . Early clinical , histological and magnetic resonance imaging responses suggest that the targeted region can be ablated with minimal adverse effects . It may represent an alternate treatment approach to observation or delayed st and ard therapy in carefully selected patients . Further trials are required to demonstrate the effectiveness of this treatment concept OBJECTIVES Owing to the ability to better detect small-volume tumors , we have seen an increasing population of men with low-risk unifocal prostate cancer . We report our safety and efficacy experience of focal cryoablation of the prostate to maintain potency and preserve genitourinary function in men with localized , unifocal disease . METHODS From June 2002 to December 2005 , 25 patients with primary unifocal prostate cancer were treated with focal cryoablation of the prostate . The patients were followed up with physical examinations , morbidity question naires , and prostate-specific antigen ( PSA ) determinations every 3 months for the first year and every 6 to 12 months thereafter . Patients with a PSA nadir greater than 1.0 ng/mL or a nadir plus 2 ng/mL underwent repeat biopsy to assess for cancer recurrence . RESULTS The median age was 68 years ( range 48 to 78 ) . The median preoperative PSA level was 6.0 ng/mL , and the postoperative PSA nadir was 2.4 ng/mL. The median follow-up was 28 months . Seventeen patients remained potent . No patients reported worsened lower urinary tract symptoms , incontinence , rectal pain , perineal discomfort , or fistula formation . The median PSA nadir was 2.4 ng/mL , and 40 % of patients had a PSA nadir of less than 1.0 ng/mL. Of the 25 patients , 21 ( 84 % ) had not experienced biochemical failure , defined as a greater than 50 % PSA nadir reduction . Seven patients underwent repeat biopsy , and prostate cancer was detected in the contralateral gl and in 2 patients and in the area of previous cryosurgery in 1 patient . CONCLUSIONS Focal cryoablation of the prostate has exhibited minimal morbidity and promising efficacy in our 3-year observation . Longer follow-up is necessary to determine its role in the treatment of patients with low-risk unifocal prostate cancer BACKGROUND The prostate component of the Prostate , Lung , Colorectal , and Ovarian ( PLCO ) Cancer Screening Trial was undertaken to determine whether there is a reduction in prostate cancer mortality from screening using serum prostate-specific antigen ( PSA ) testing and digital rectal examination ( DRE ) . Mortality after 7 - 10 years of follow-up has been reported previously . We report extended follow-up to 13 years after the trial . METHODS A total of 76 685 men , aged 55 - 74 years , were enrolled at 10 screening centers between November 1993 and July 2001 and r and omly assigned to the intervention  ( organized screening of annual PSA testing for 6 years and annual DRE for 4 years ; 38 340 men ) and control ( usual care , which sometimes included opportunistic screening ; 38 345 men ) arms . Screening was completed in October 2006 . All incident prostate cancers and deaths from prostate cancer through 13 years of follow-up or through December 31 , 2009 , were ascertained . Relative risks ( RRs ) were estimated as the ratio of observed rates in the intervention and control arms , and 95 % confidence intervals ( CIs ) were calculated assuming a Poisson distribution for the number of events . Poisson regression modeling was used to examine the interactions with respect to prostate cancer mortality between trial arm and age , comorbidity status , and pretrial PSA testing . All statistical tests were two-sided . RESULTS Approximately 92 % of the study participants were followed to 10 years and 57 % to 13 years . At 13 years , 4250 participants had been diagnosed with prostate cancer in the intervention arm compared with 3815 in the control arm . Cumulative incidence rates for prostate cancer in the intervention and control arms were 108.4 and 97.1 per 10 000 person-years , respectively , result ing in a relative increase of 12 % in the intervention arm ( RR = 1.12 , 95 % CI = 1.07 to 1.17 ) . After 13 years of follow-up , the cumulative mortality rates from prostate cancer in the intervention and control arms were 3.7 and 3.4 deaths per 10 000 person-years , respectively , result ing in a non-statistically significant difference between the two arms ( RR = 1.09 , 95 % CI = 0.87 to 1.36 ) . No statistically significant interactions with respect to prostate cancer mortality were observed between trial arm and age ( P(interaction ) = .81 ) , pretrial PSA testing ( P(interaction ) = .52 ) , and comorbidity ( P(interaction ) = .68 ) . CONCLUSIONS After 13 years of follow-up , there was no evidence of a mortality benefit for organized annual screening in the PLCO trial compared with opportunistic screening , which forms part of usual care , and there was no apparent interaction with age , baseline comorbidity , or pretrial PSA testing PURPOSE Patients currently diagnosed with low risk prostate cancer are often overtreated and experience complications , result ing in detriment to quality of life . Targeted focal therapy is a minimally invasive procedure design ed to ablate tumor foci while minimizing collateral damage to maintain quality of life . MATERIAL S AND METHODS This institutional review board approved , prospect i ve study was done to assess the safety and efficacy of targeted focal therapy using cryotherapy in men 40 to 85 years old diagnosed with low risk , organ confined prostate cancer at our institution between 2006 and 2009 . Low risk , organ confined prostate cancer was defined as Gleason score 7 or less ( 3 + 4 ) on transrectal ultrasound biopsy , tumor burden 50 % or less and prostate specific antigen less than 10 ng/dl . Patients were evaluated for eligibility after undergoing 3-dimensional mapping biopsy . Median followup was 28 months ( IQR 26 - 31 ) . RESULTS A total of 62 men with low risk disease met study inclusion criteria . At 1 year biopsy was negative in 50 of 62 patients ( 81 % ) . All 12 men who tested positive on repeat biopsy had a Gleason score of 3 + 3 = 6 with 1 or 2 positive cores . The median prostate specific antigen change was a 3.0 ng/dl decrease ( p < 0.01 ) . The median American Urological Association symptom score change was a 1.5-point decrease ( p < 0.01 ) . No significant change was observed in Sexual Health Inventory for Men score ( p = 0.6 ) . No urinary incontinence episodes and no severe side effects were noted . CONCLUSIONS Targeted focal therapy in carefully selected patients provides a feasible , practical option for treating low risk prostate cancer with minimal impact on quality of life To  assess oncological ( biochemical and histological recurrence ) and functional ( urinary and potency ) outcomes in patients with unilateral low‐risk organ‐confined prostate cancer ( PCa ) treated with focal cryoablation ( FC ) OBJECTIVES To determine whether high-dose radiation delivered to a subvolume of the prostate gl and ( peripheral zone ) using intraoperative magnetic resonance imaging-guided brachytherapy provided comparable 5-year prostate-specific antigen ( PSA ) control rates to radical prostatectomy ( RP ) in select patients compared prospect ively but in a nonr and omized setting . METHODS Between 1997 and 2002 , 322 and  
    Output:
    
The outcomes of FT in PCa seem to be similar to those observed with whole gl and therapy and with fewer side effects .