So, uh, what's your opinion, Lars? Why in the era of the MRI, uh, driven pathway, we still need a, a, a systematic biopsy, or at least information from the, uh, contralateral biopsy to indicate and plan our focal therapy?

therapy?Yeah, I think it's an important issue since the targeted biopsy and the perineural, uh, sampling is adequate for lesion categorizations.

However, um, focused therapy requires confidence that the untreated lobe does not harbor relevant occult disease, and therefore we need to get everything out of the diagnostic pathway which is possible.

And, uh, therefore, the consensus explicitly supports the targeted and the perineur- lesional biopsy on the one side, and also the contralateral systematic biopsy to, uh, reduce the undertreatment of MRI invisible lesions in this opposite lobe.

So by lacking this information, how do you think this might affect the indication of one or another approach during radical prostatectomy?

So basically, in our institution, what we do is this, uh, neurosafe approach where we, uh, slice some parts of the prostate and send it to the pathologist, and they provide us with the information on the margin.

And for sure, they also provide us with further information on the Gleason score so we can opt for or against lymph node dissection.

However, for nerve sparing in the consensus, the panel considered that targeted biopsy and peri-lesional biopsies are sufficient in unifocal disease and, uh, sufficient in bilateral MRI visible disease.