Prostate Cancer Outcomes after HIFU: 5-Year FFS Variations by ISUP Grade Group

What is it about?

This study reports the 5-year failure-free survival (FFS) following high-intensity focused ultrasound (HIFU) for clinically localized prostate cancer in England. The FFS was 96.5% at 1 year, 86.0% at 3 years, and 77.5% at 5 years. The FFS was strongly associated with ISUP Grade Group, with men in the two highest ISUP Grade Groups having poor outcomes. One in five men undergoing HIFU will experience treatment failure requiring salvage intervention within 5 years of their primary HIFU treatment. The study is based on linked national clinical and administrative hospital data and is one of the largest case series published to date.

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Why is it important?

This research is important as it provides valuable information on the outcomes of high-intensity focused ultrasound (HIFU) treatment for clinically localized prostate cancer. By analyzing data from a large cohort of 1381 men in England who underwent HIFU between 2010 and 2018, the study offers insights into the failure-free survival (FFS) and other clinical outcomes. These findings can help patients and healthcare professionals make better-informed decisions about the suitability of HIFU as a treatment option. Key Takeaways: 1. The median FFS at 5 years was 77.5%, with significantly lower rates for men in higher ISUP Grade Groups. 2. The 5-year FFS for ISUP Grade Groups 1-5 was 82.9%, 76.6%, 72.2%, 52.3%, and 30.8%, respectively. 3. Freedom from repeat HIFU was 79.1%, and overall survival (OS) and prostate cancer-specific survival (CSS) were 95.9% and 98.8%, respectively, at 5 years. 4. About 1 in 100 men with prostate cancer will die from their disease, and 1 in 5 men undergoing HIFU will experience treatment failure within 5 years. 5. The study's definition of FFS did not include the avoidance of systemic therapy or metastasis development, which could have a minor impact on the results. 6. Future studies should link data from clinical registries with routinely collected cancer registry and administrative hospital datasets to better understand the long-term outcomes of HIFU treatment for prostate cancer.