[Local recurrence of prostate cancer after curative therapy. HIFU (Ablatherm) as a treatment option]

In terms of effectivity and impact, no ideal approach is as yet available for treatment of local recurrence of prostate cancer. We direct our attention mainly toward high-intensity focused ultrasound (HIFU). HIFU therapy (Ablatherm) is only performed in our department when the following criteria are met: the recurrent tumor must be visualizable with imaging procedures (for HIFU, transrectal ultrasound is employed), the tumor must be accessible to the scanner head (penetration depth: 25 mm), and finally the diagnosis of recurrent tumor has to be histologically confirmed. An indisputable advantage of HIFU is the option of easily administering HIFU therapy for a second time in the presence of tumor remnants or in the event of cancer recurrence. Depending on the primary cancer treatment given, salvage HIFU achieves a biopsy-proven tumor-free state in 60-74% of patients. These results are in line with those that can be obtained with other salvage strategies (radical prostatectomy, radiation therapy). However HIFU shows reduced postoperative morbidity with less side effects.