Feasibility and early outcomes of salvage robot-assisted radical prostatectomy after focal therapy failure for localized prostate cancer

Introduction

Prostate cancer, a common malignant tumor among men worldwide, has shown a significant increasing trend in incidence in recent years, becoming a major public health problem threatening men’s health. It ranks second in incidence and fifth in mortality among male malignant tumors globally (1). Focal therapeutic techniques, such as laser ablation (LA) and radiofrequency ablation (RFA), have become important treatment options for selected patients with low- to intermediate-risk localized prostate cancer (2). These approaches achieve good medium-term oncological control while significantly reducing impacts on urinary continence and sexual function, while high-level evidence from long-term studies remains scarce (3). However, focal therapy (FT) does not achieve a curative outcome for all patients. The coexistence of treated and untreated regions within the prostate complicates conventional monitoring approaches based on prostate-specific antigen (PSA) and multiparametric magnetic resonance imaging (mpMRI). Current postoperative surveillance for prostate cancer primarily relies on PSA follow-up and systematic biopsy guided by imaging evaluation, now typically performed as mpMRI-targeted biopsy to precisely localize recurrent or residual cancerous lesions. Despite these advancements, mpMRI retains limitations. In the complex imaging background following FT, the diagnostic accuracy of conventional MRI relying on T2-weighted morphological characteristics is significantly compromised due to diffuse tissue alterations (4).

Molecular imaging plays an increasingly vital role in the precise diagnosis of prostate cancer, with prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) demonstrating particularly prominent advantages for primary staging of metastatic disease (5). Compared to mpMRI, PSMA PET/CT exhibits superior sensitivity in detecting prostate cancer lesions. Studies have confirmed that for lesions with indeterminate findings on mpMRI, PSMA PET/CT significantly enhances the diagnostic capability for clinically significant prostate cancer (csPCa) by leveraging its strengths in molecular imaging, thereby optimizing clinical decision-making (6). Existing studies have demonstrated that PSMA PET/CT is a powerful tool for detecting recurrent prostate cancer, superior to mpMRI. It maintains high detection rates even at low PSA levels, thereby enabling the possibility of early intervention (7).

In the management of recurrent prostate cancer after FT, salvage options include repeat FT, salvage radiotherapy (SRT), and salvage robot-assisted radical prostatectomy (S-RARP). Procedure-related morbidity remains an important consideration, particularly when pelvic lymph node dissection is required, with symptomatic lymphocele representing a clinically relevant complication after RARP (8). The pad-free rates for S-RARP (77.2%) and SRT (75.0%) show no significant difference in the medium to long term after treatment (9). S-RARP demonstrated favorable functional and oncological outcomes for patients with csPCa recurrence or residual disease following focal irreversible electroporation (IRE) ablation (10).

By analyzing the long-term outcomes of radical prostatectomy and comparing the diagnostic efficacy of PSMA PET/CT and mpMRI for recurrence, this research aims to describe the feasibility and early outcomes of S-RARP in patients with recurrent disease and explore whether PSMA PET/CT may provide incremental value over mpMRI for detecting recurrence after FT. We present this article in accordance with the STROBE reporting checklist (available at https://tau.amegroups.com/article/view/10.21037/tau-2026-0439/rc).

Methods

Patient characteristics

A retrospective analysis was conducted on the clinical data of 8 patients with low- and intermediate-risk localized prostate cancer who underwent S-RARP at the Affiliated Drum Tower Hospital of Nanjing University Medical School between November 3, 2019, and November 24, 2022. These patients had experienced disease recurrence following initial FT with RFA or LA. All FT procedures and subsequent salvage surgeries were performed by the same urologist to ensure procedural consistency. Prior to the procedure, all patients were fully informed about the advantages and disadvantages of focal RFA treatment, the potential need for long-term follow-up, and other available treatment options, and were required to sign an informed consent form. S-RARP was preferentially considered for patients without distant metastases who were surgically eligible and desired definitive local treatment, whereas ADT, repeat FT, radiotherapy, or surveillance was selected as appropriate for other patients. This study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Ethics Committee of Nanjing Drum Tower Hospital (No. 2202-261-602). Informed consent was taken from all the patients.

Inclusion criteria were as follows: (I) initially diagnosed localized low-to-intermediate risk localized prostate cancer; (II) prior FT with RFA or LA at our center; (III) pathologically confirmed local residual/recurrent disease after FT; (IV) subsequent S-RARP at Nanjing Drum Tower Hospital between November, 2019, and November, 2022. Exclusion criteria were as follows: (I) no pathological confirmation of local residual/recurrent disease after FT; (II) receipt of non-surgical salvage treatment instead of S-RARP; (III) underwent surveillance or received androgen deprivation therapy (ADT) prior to FT; (IV) incomplete clinical data.

RFA and LA

All patients underwent preoperative mpMRI, and suspicious lesions were jointly reviewed by urologists and radiologists before confirmation by targeted transperineal prostate biopsy. For RFA, patients received intravenous antibiotic prophylaxis and were treated under local anesthesia in the lithotomy position. A Foley catheter was inserted, and TRUS was used to visualize the prostate, urethra, bladder, seminal vesicles, and anterior rectal wall. MRI-defined lesions were localized using MRI-TRUS fusion imaging with the Esaote MyLabTwice system, after which an ablation coil was introduced percutaneously through the perineum into the target lesion. Once the inner needle established a complete bipolar circuit, RFA was performed with energy progressively increased according to the manufacturer’s protocol until the preset ablation time was completed. For LA, under local anesthesia and real-time ultrasound guidance, a trocar and dual-lumen introducing catheter were advanced into the lesion, followed by insertion of a 980-nm diode laser fiber connected to continuous room-temperature saline cooling. Laser power was set at 10–15 W, and each lesion received an average of three to four ablation cycles, each lasting 2 min. The target ablation temperature was maintained at 60–90 ℃, while adjacent structures, including the urethra and rectal wall, were kept within a safe range of 30–42 ℃. Patients were discharged on the same day with an indwelling urethral catheter and postoperative prophylactic antibiotics, analgesics, and alpha-blockers.

Imaging protocols

For mpMRI, lesion evaluation included at least high-resolution T2-weighted imaging in three planes, adequate diffusion-weighted imaging with corresponding apparent diffusion coefficient maps, and, when available, dynamic contrast-enhanced sequences, consistent with current guideline recommendations (11).

After intravenous injection of a radiolabeled tracer like ⁶⁸Ga-PSMA-11, hybrid PET/CT or PET/MRI imaging is performed. Patients received an intravenous injection of ⁶⁸Ga-PSMA-11 at an activity of 1.8–2.2 MBq/kg. PET/CT acquisition was started at least 60 min after tracer administration. The acquired images are analyzed to delineate suspicious lesions based on PSMA uptake (12). Intraprostatic PSMA PET/CT positivity was defined according to the PRIMARY score. PRIMARY scores 1–2 was considered negative, whereas PRIMARY scores 3–5 was considered positive, score of 5 corresponded to an SUVmax ≥12 (6).

Histopathological analysis

A standardized protocol for processing radical prostatectomy specimens was utilized. Following resection of the seminal vesicles and apex/base, the prostate was oriented according to its axial angle on preoperative T2-weighted MRI. The gland was sectioned serially from apex to base at 5 mm intervals. Tissue slices were then processed into 5-μm whole-mount sections and stained with hematoxylin and eosin (H&E). Experienced uropathologists evaluated these large-format sections according to the 2014 ISUP grading system. Pathological reports documented Gleason scores (primary and secondary), lesion location, capsular and seminal vesicle invasion, and primary lesion identification. For analysis, pathological grading was dichotomized into high-grade (ISUP Grade Group ≥3) and low-grade (ISUP Grade Group ≤2) disease at the whole-gland level. Staging was categorized as locally advanced (≥pT3) or organ-confined (pT2).

Follow up and evaluations

As illustrated in Figure S1, following FT, patients underwent regular surveillance, including physical examination, PSA testing, and imaging assessment. PSA was measured within 3 months after treatment, every 3 months during the first year, and every 6 months thereafter. mpMRI was routinely scheduled at 6 and 12 months after FT and was performed earlier in patients with PSA progression or persistent clinical suspicion of recurrence. Patients without PSA progression or other clinically suspicious findings continued routine surveillance according to the predefined schedule. PSA progression or persistent clinical suspicion prompted further diagnostic evaluation. mpMRI served as the primary imaging modality for reassessment, whereas PSMA PET/CT (or PET/MRI) was not routinely used for surveillance but was selectively considered in patients with PSA progression, equivocal mpMRI findings, or persistent clinical suspicion despite negative or inconclusive mpMRI findings.

Repeat prostate biopsy was not performed as a routine screening procedure but was used for pathological confirmation when FT failure was clinically suspected. When imaging revealed a suspicious lesion, combined targeted and systematic biopsy was preferentially performed; when imaging findings were negative or equivocal but PSA continued to rise, systematic biopsy was considered.

Functional outcomes and postoperative complications were documented during follow-up visits. Functional outcomes, including urinary continence, erectile function, and pad use, were recorded during follow-up. Erectile function was assessed using the IIEF score or documented erectile function status when available, and postoperative complications after S-RARP were graded according to the Clavien-Dindo classification.

Statistical analysis

Continuous variables are summarized, depending on their distribution, as either median with interquartile range (IQR) or mean with standard deviation (SD). For small sample sizes, the median and range are additionally reported to better reflect the data distribution. Categorical variables are presented as absolute frequencies and relative frequencies (e.g., percentages).

Results

Patient characteristics

This study analyzed 8 patients who underwent S-RARP following disease recurrence after initial FT. At initial diagnosis, the patients had relatively early-stage disease. As outlined in Table 1, prior to FT, the median patient age was 68 years, with a mean PSA of 7.01 ng/mL. The vast majority (75%) had a Gleason score of 3+3. However, upon disease recurrence leading to S-RARP, signs of progression were observed: biopsy revealed Gleason score upgrading, with 50% of cases scored 3+4 or higher, including one high-risk case of 4+5. The median interval from FT to salvage surgery was 19 months. Final postoperative pathology showed a broader distribution of disease grade, with 37.5% of cases being ISUP Grade Group 3 or higher, including one case (12.5%) of ISUP Grade Group 5. Notably, nearly half of the patients experienced out-of-field recurrence, and the vast majority (75%) exhibited pathological upgrading.

All 8 patients underwent mpMRI both before initial FT and prior to S-RARP. The majority of patients (87.5%) before FT had PI-RADS scores of 3 or 4. Before S-RARP, four patients showed PSA progression and positive pathological result without a corresponding positive lesion on mpMRI. PSMA PET/CT or PSMA PET/MRI was performed before initial FT in three patients, with reported positive lesions generally consistent with the locations identified on the initial mpMRI. Additionally, two patients underwent PSMA PET/CT before S-RARP, and the reported positive lesions largely correlated with the locations (Patient A: PRIMARY Score 4, Patient B: PRIMARY Score 3) confirmed by postoperative pathological sections.

Outcome analysis

The perioperative and functional outcomes of the 8 patients is detailed in Tables 2,3 are summarized as follows. The mean operative time was 157.5 minutes (SD, 41.49 min), with a median hospital stay of 6 days (IQR, 5.5–8 day). The mean intraoperative blood loss was 125 mL (range, 50–300 mL). Intraoperative findings during S-RARP revealed well-defined anatomical layers and an absence of notable adhesions. As shown in Figure S2, after a median follow-up of approximately 21 months (IQR, 18–40 months), none of the patients experienced biochemical recurrence (BCR), and postoperative PSA control was favorable after S-RARP, with PSA levels rapidly declining to or below the detection limit in all patients. Final pathological analysis of the surgical specimens confirmed negative surgical margins in all cases. Six patients underwent unilateral nerve-sparing, while the remaining two underwent partial nerve-sparing procedures. Following catheter removal, all patients recovered urinary continence, while postoperative erectile function recovery was generally limited. No Clavien-Dindo grade II or higher complications were observed.

Discussion

Focal tissue-preserving therapies for prostate cancer, such as RFA and LA, are designed to reduce the adverse effects associated with overtreatment (13). FT using RFA for prostate cancer patients with MRI-detectable lesions is effective in achieving early ablation and is associated with low rates of genitourinary and rectal adverse events (14). However, previous literature has reported that the mid-term clinically significant BCR rate after FT can be as high as 43%, and approximately 33% of patients require further local treatment (9). Current preliminary evidence suggests significant variability in oncological control rates and functional preservation outcomes (urinary and sexual) among various focal therapeutic modalities (15). Studies indicated that approximately 10–30% of patients may require conversion to traditional whole-gland treatments within medium-term follow-up due to residual disease, recurrence, or emergence of new lesions (16). A study demonstrated that the 5-year freedom from local salvage treatment and cancer-specific mortality (FFS) following primary high-intensity focused ultrasound (HIFU) in the UK was 78%, indicating that a proportion of patients may require repeat FT, with the likelihood correlating with tumor grade (17).

The current clinical diagnosis of suspected recurrence following FT necessitates a multimodal approach that synthesizes findings from laboratory tests (specifically PSA levels), mpMRI, and pathological evaluation (18). Within this integrated diagnostic pathway, needle biopsy remains the most critical and accurate modality for the early and precise detection of local recurrence.

This report presents preliminary single-center experience regarding S-RARP after FT, including surgical feasibility, imaging findings during post-operative monitoring of disease recurrence, and early functional and oncological outcomes. To date, the literature on surgery following FT remains limited, characterized by small cohort sizes and a paucity of studies specifically investigating the optimal choice of imaging techniques for monitoring disease recurrence.

Based on the integration of radiographic (mpMRI and PSMA PET/CT) and histopathological (postoperative tissue pathology) findings from the eight patients with recurrence, which revealed that 50% (4/8) developed out-of-field recurrence and 75% (6/8) exhibited pathological upgrading after initial FT. A positive repeat biopsy confirming recurrence may prompt consideration of radical prostatectomy, whose feasibility and acceptable complication profile after FT failure have been reported in prior studies (19). Postoperative pathological analysis of the surgical specimen may help guide subsequent decisions regarding adjuvant therapies, such as ADT and radiotherapy (20). Despite concerns that prior ablation may lead to fibrosis, tissue distortion, and potentially more difficult surgical dissection, available evidence suggests that S-RARP is technically feasible in selected patients after FT failure. In our cohort, S-RARP could be completed without major intraoperative difficulty, with clearly identifiable anatomical planes and no rectourethral fistula. These findings support the feasibility of S-RARP as a salvage option following FT failure, while recognizing that larger multicenter studies with longer follow-up are required to determine its long-term oncological and functional outcomes.

All eight patients with recurrence underwent mpMRI examinations prior to repeat biopsy. In four of these patients, referring to Figure 1, mpMRI findings were unremarkable, showing only post-treatment changes consistent with the sequelae of FT for prostate cancer, with no clearly identifiable recurrent lesions. In selected patients, PSMA PET/CT helped localize suspicious recurrent foci and assess disease burden. These observations suggest that PSMA PET/CT may be a useful complementary tool when mpMRI findings are negative or equivocal after FT.

Figure 1 Correlation of preoperative imaging and postoperative histopathology for localizing prostate cancer lesions. The whole-mount H&E sections were scanned at ×20 magnification. ADC, apparent diffusion coefficient; DWI, diffusion-weighted imaging; FT, focal therapy; H&E, hematoxylin and eosin; PSMA PET/CT, prostate-specific membrane antigen positron emission tomography/computed tomography; S-RARP, salvage robot-assisted radical prostatectomy.

Focal therapies, including HIFU, RFA, and LA, are designed to achieve precise ablation of tumor tissue while maximizing the preservation of surrounding healthy structures. However, post-treatment alterations such as hemorrhage, coagulative necrosis, inflammation, fibrosis, and architectural distortion may alter MRI signal characteristics and complicate the interpretation of post-treatment prostate imaging. These changes may mimic or obscure residual or recurrent tumor on mpMRI, thereby increasing the diagnostic complexity of local recurrence assessment (4). In contrast to conventional imaging modalities, PSMA PET/CT is a nuclear medicine imaging technique based on molecular functional imaging. Consequently, when evaluating prostate regions that have undergone FT, PSMA PET/CT demonstrates significantly improved diagnostic sensitivity for detecting recurrence. Its accuracy remains largely unaffected by the complex background interference commonly seen after treatment, such as architectural disruption, fibrosis, or hemorrhage (21). In this context, PSMA PET/CT may provide complementary molecular information when mpMRI findings are equivocal or difficult to interpret, but its role should be considered adjunctive rather than definitive.

This study has several important limitations. First, its single-center retrospective design may be subject to selection bias. Second, the sample size was small (n=8). In our clinical practice, relatively few patients with prostate cancer are eligible for and undergo FT, and even fewer subsequently undergo S-RARP after FT failure, inherently limiting the number of eligible cases. Nevertheless, the patients were consecutively included and may therefore reflect, to some extent, real-world practice at our center. Given the limited sample size, this study primarily aimed to provide a preliminary assessment of the technical feasibility, perioperative safety, and early functional and oncological outcomes of S-RARP after FT failure, thereby providing initial evidence for larger future studies. In addition, PSMA PET/CT was not performed uniformly in all patients, limiting direct comparisons among imaging modalities. Third, the relatively short follow-up precluded robust assessment of durable oncological control and long-term functional outcomes. Accordingly, the present findings are insufficient to establish the efficacy or long-term oncological control of S-RARP or to support definitive recommendations regarding PSMA PET/CT-based surveillance. Larger multicenter prospective studies with long-term follow-up are warranted to validate these preliminary findings and provide more robust evidence to guide the management of patients with localized prostate cancer who develop recurrence after FT.

Conclusions

In conclusion, in this small single-center retrospective cohort of selected patients with recurrent disease after FT, S-RARP appeared to be a technically feasible salvage option and was associated with promising early oncological and functional findings. PSMA PET/CT may complement mpMRI for recurrence localization in selected patients after FT.

Acknowledgments

None.

Footnote

Reporting Checklist: The authors have completed the STROBE reporting checklist. Available at https://tau.amegroups.com/article/view/10.21037/tau-2026-0439/rc

Data Sharing Statement: Available at https://tau.amegroups.com/article/view/10.21037/tau-2026-0439/dss

Peer Review File: Available at https://tau.amegroups.com/article/view/10.21037/tau-2026-0439/prf

Funding: This work was supported by the National Natural Science Foundation of China (No. 82473415).

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tau.amegroups.com/article/view/10.21037/tau-2026-0439/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. This study was conducted in accordance with the Declaration of Helsinki and its subsequent amendments. The study was approved by the Ethics Committee of Nanjing Drum Tower Hospital (No. 2202-261-602). Informed consent was taken from all the patients.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

References

1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2021;71:209-49. [Crossref] [PubMed]
2. Ghoreifi A, Gomella L, Hu JC, et al. Identifying the best candidate for focal therapy: a comprehensive review. Prostate Cancer Prostatic Dis 2025;28:684-92. [Crossref] [PubMed]
3. Tay KJ, Fong KY, Stabile A, et al. Established focal therapy-HIFU, IRE, or cryotherapy-where are we now?-a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2025;28:693-706. [Crossref] [PubMed]
4. Lai AL, Velaga J, Tay KJ, et al. Multiparametric MRI before and after Focal Therapy for Prostate Cancer: Pearls and Pitfalls for the Reporting Radiologist. Radiol Imaging Cancer 2025;7:e240269. [Crossref] [PubMed]
5. Jochumsen MR, Bouchelouche K. PSMA PET/CT for Primary Staging of Prostate Cancer - An Updated Overview. Semin Nucl Med 2024;54:39-45. [Crossref] [PubMed]
6. Emmett L, Papa N, Buteau J, et al. The PRIMARY Score: Using Intraprostatic 68Ga-PSMA PET/CT Patterns to Optimize Prostate Cancer Diagnosis. J Nucl Med 2022;63:1644-50. [Crossref] [PubMed]
7. Burgard C, Frei M, Blickle A, et al. PSMA PET/CT in biochemical recurrence of prostate cancer with PSA levels ≤ 0.2 ng/mL: a German multicenter analysis of conventional PSMA tracers, including 68GaGa-PSMA-11, 68GaGa-PSMA I&T, and 18FPSMA-1007. Eur J Nucl Med Mol Imaging 2025;52:4368-76. [Crossref] [PubMed]
8. Sforza S, Tellini R, Grosso AA, et al. Can we predict the development of symptomatic lymphocele following robot-assisted radical prostatectomy and lymph node dissection? Results from a tertiary referral Centre. Scand J Urol 2020;54:328-33. [Crossref] [PubMed]
9. Nathan A, Ng A, Mitra A, et al. Comparative Effectiveness Analyses of Salvage Prostatectomy and Salvage Radiotherapy Outcomes Following Focal or Whole-Gland Ablative Therapy (High-Intensity Focused Ultrasound, Cryotherapy or Electroporation) for Localised Prostate Cancer. Clin Oncol (R Coll Radiol) 2022;34:e69-78. [Crossref] [PubMed]
10. Blazevski A, Gondoputro W, Scheltema MJ, et al. Salvage robot-assisted radical prostatectomy following focal ablation with irreversible electroporation: feasibility, oncological and functional outcomes. BMC Urol 2022;22:28. [Crossref] [PubMed]
11. Turkbey B, Rosenkrantz AB, Haider MA, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol 2019;76:340-51. [Crossref] [PubMed]
12. Ferraro DA, Becker AS, Kranzbühler B, et al. Diagnostic performance of 68Ga-PSMA-11 PET/MRI-guided biopsy in patients with suspected prostate cancer: a prospective single-center study. Eur J Nucl Med Mol Imaging 2021;48:3315-24. [Crossref] [PubMed]
13. Hopstaken JS, Bomers JGR, Sedelaar MJP, et al. An Updated Systematic Review on Focal Therapy in Localized Prostate Cancer: What Has Changed over the Past 5 Years?. Eur Urol 2022;81:5-33. [Crossref] [PubMed]
14. Orczyk C, Barratt D, Brew-Graves C, et al. Prostate Radiofrequency Focal Ablation (ProRAFT) Trial: A Prospective Development Study Evaluating a Bipolar Radiofrequency Device to Treat Prostate Cancer. J Urol 2021;205:1090-9. [Crossref] [PubMed]
15. Heard JR, Naser-Tavakolian A, Nazmifar M, et al. Focal prostate cancer therapy in the era of multiparametric MRI: a review of options and outcomes. Prostate Cancer Prostatic Dis 2023;26:218-27. [Crossref] [PubMed]
16. Fujihara A, Ukimura O. Focal therapy of localized prostate cancer. Int J Urol 2022;29:1254-63. [Crossref] [PubMed]
17. Parry MG, Sujenthiran A, Nossiter J, et al. Prostate cancer outcomes following whole-gland and focal high-intensity focused ultrasound. BJU Int 2023;132:568-74. [Crossref] [PubMed]
18. Koehler J, Han S, Tremblay S, et al. Surveillance After Focal Therapy for Prostate Cancer: A Comprehensive Review. Cancers (Basel) 2025;17:1337. [Crossref] [PubMed]
19. Nunes-Silva I, Barret E, Srougi V, et al. Effect of Prior Focal Therapy on Perioperative, Oncologic and Functional Outcomes of Salvage Robotic Assisted Radical Prostatectomy. J Urol 2017;198:1069-76. [Crossref] [PubMed]
20. Kishan AU, Sun Y, Parker CC, et al. Hormone therapy use and duration with postoperative radiotherapy for recurrent prostate cancer: an individual patient data meta-analysis. Lancet 2026;407:1059-71. [Crossref] [PubMed]
21. Nicoletti R, Alberti A, Gauhar V, et al. Is there a role of PSMA-PET in focal therapy planning and follow-up?. Prostate Cancer Prostatic Dis 2026;29:28-35. [Crossref] [PubMed]