# 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

## TL;DR

A patient who had microwave therapy for prostate cancer later underwent robotic surgery, which confirmed the therapy's success and found new cancer in a different area.

## Contribution

This case demonstrates the effectiveness of microwave ablation and the safety of subsequent robotic surgery.

## Key findings

- Microwave ablation resulted in no viable cancer cells in the treated area.
- A new cancer lesion was identified in the left peripheral zone after PSA increase.

## Abstract

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.

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.

RARP was safely performed even after MFT and proved the pathological complete response of microwave ablation.