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Focal Laser Ablation of Prostate Cancer: An Office Procedure

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Prospective Evaluation of Focal High Intensity Focused Ultrasound for Localized Prostate Cancer.

Bruno Nahar^1,2, Abhishek Bhat¹, Isildinha M Reis^3,4

¹Department of Urology, University of Miami Miller School of Medicine, Miami, Florida.

The Journal of Urology

|March 14, 2020

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Focal high intensity focused ultrasound (HIFU) shows promise for localized prostate cancer, demonstrating good short-term results. This minimally invasive treatment is safe and effective, though longer follow-up is needed.

Area of Science:

Oncology
Urology
Medical Technology

Background:

Prostate cancer is a significant health concern globally.
Minimally invasive treatment options are increasingly sought for localized prostate cancer.
Focal therapies offer a potential alternative to whole-gland treatments.

Purpose of the Study:

To evaluate the short-term outcomes of focal high intensity focused ultrasound (HIFU) as a primary treatment for localized prostate cancer.
To assess the oncologic control and functional outcomes following focal HIFU.
To determine the safety and complication profile of focal HIFU in this patient cohort.

Main Methods:

Prospective data collection from a single center (January 2016 - July 2018).
Inclusion of patients with localized prostate cancer undergoing primary focal HIFU.

Keywords:

prostatic neoplasms treatment outcome ultrasound

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Assessment of oncologic control via in-field biopsy, PSA levels, and validated quality-of-life questionnaires (SHIM, IPSS, EAPCID).

Main Results:

52 patients with a minimum 12-month follow-up were included.
83% of patients with follow-up biopsies achieved negative in-field results, indicating oncologic control.
Urinary symptoms and sexual function returned to near-baseline levels within 3-12 months.
Only 5 major complications (Grade III) were reported in 4 patients.

Conclusions:

Focal HIFU is a safe and effective primary treatment for localized, clinically significant prostate cancer.
Acceptable short-term oncologic and functional outcomes were observed.
While promising, longer follow-up is necessary to confirm long-term efficacy and durability.