Evaluating long-term outcomes after high-intensity focused ultrasound for prostate cancer

This study evaluated the long-term outcomes of patients who underwent whole-gland high-intensity focused ultrasound (HIFU) for non-metastatic prostate cancer. The data showed that HIFU has favorable outcomes in low- and intermediate-risk groups of patients.

HIFU is a treatment option for prostate cancer (PCa) that is limited to the prostate itself (localized). This means it has not yet spread beyond the prostate or to distant organs (metastasis). HIFU uses high-frequency ultrasound waves to heat and destroy cancer cells in the prostate.

HIFU can be used in half of the prostate gland (hemi-gland) or on the whole prostate gland (whole-gland). However, the long-term outcomes after whole-gland HIFU treatment in patients with localized PCa are not well known.

This study involved 560 patients with non-metastatic PCa who received whole-gland HIFU. The patients were classified into 3 risk groups: low risk (LR), intermediate-risk (IR), and high risk (HR) PCa. The average follow-up time was 15.1 years with a maximum of 21.4 years.

Overall, 57% of all patients were alive after 15 years. The 15-year overall survival rates were 66% for LR, 56% for IR, and 35% for HR groups.

The 15-year cancer-specific survival rates were 95% for LR, 89% for IR, and 65% for the HR group. 91% of the LR group, 85% of the IR group, and 58% of the HR group were alive after 15 years without any metastasis.

This study concluded that HIFU achieved good long-term cancer control in low- and intermediate-risk patients. Since the performance was poor in high-risk patients, the authors suggest they should not be treated routinely by HIFU.

The study population was small and was conducted at a single institution. The researchers did not compare HIFU to other forms of prostate cancer treatment in a controlled manner.