Cancer Control Outcomes Following Focal Therapy Using High-intensity Focused Ultrasound in 1379 Men with...

Area of Science:

• Oncology
• Urology
• Medical Technology

Background:

• Focal therapy treats localized cancer, aiming for oncological control while minimizing functional side effects.
• High-intensity focused ultrasound (HIFU) is an emerging focal therapy for prostate cancer.

Purpose of the Study:

• To evaluate oncological outcomes and adverse events of focal HIFU for nonmetastatic prostate cancer.
• To assess the efficacy of focal HIFU in different D'Amico risk groups.

Main Methods:

• Analysis of 1379 patients from the HIFU Evaluation and Assessment of Treatment (HEAT) registry (2005-2020).
• Focal HIFU delivered via transrectal ultrasound-guided device.
• Failure-free survival (FFS) defined by absence of salvage treatment, metastases, or cancer-specific mortality.
• Adverse events classified using Clavien-Dindo system.

Main Results:

• Median follow-up was 32 months; 24% of patients had ≥5 years of follow-up.
• Seven-year FFS was 69% overall (64-74%).
• Seven-year FFS for intermediate-risk and high-risk cancers was 68% and 65%, respectively.
• Fewer than 1% (0.5%) of patients experienced Clavien-Dindo grade >2 adverse events.

Conclusions:

• Focal HIFU provides effective medium-term cancer control for carefully selected prostate cancer patients.
• The treatment is associated with a low rate of severe adverse events.
• Longer-term (10-year) follow-up data are needed for a complete assessment.