Focal HIFU for Prostate Cancer: 3-Year Outcomes and Functional Outcomes

What is it about?

This study assessed the oncological and functional outcomes of focal high-intensity focused ultrasound (HIFU) in treating localized prostate cancer (PCa). A 3-year prospective study was conducted using periodic post-ablation saturation biopsies. Men with two or fewer lesions of grade group (GG) ≤3 PCa were eligible for participation. The primary endpoint was failure-free survival (FFS), defined as the absence of clinically significant PCa (csPCa) in-or out-of-field on protocol-mandated saturation biopsy, no whole-gland or systemic salvage treatment, PCa metastasis, or PCa-related death. Results were reported using two distinct definitions of csPCa. Secondary endpoints were functional patient-reported outcome measures addressing urinary, sexual, and bowel function. A total of 91 patients were included, with 83 (91%) undergoing at least one follow-up biopsy. The FFS at 3 years for any GG ≥2 PCa was 44% and for any GG ≥3 or core length ≥6 mm was 65%. The 3-year cancer-specific survival was 100%, and freedom from metastasis was 99%. Early follow-up biopsies are crucial to changing or continuing the treatment modality at the right time, while the use of MRI and PSA in detecting PCa recurrence is uncertain.

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Why is it important?

This research is important because it provides valuable insights into the oncological and functional outcomes of using focal high-intensity focused ultrasound (HIFU) for treating localized prostate cancer (PCa). This study offers a 3-year prospective analysis, which is crucial for determining the long-term effectiveness of this treatment approach. Understanding the outcomes of focal HIFU can help patients and healthcare providers make informed decisions about the best treatment options for localized PCa. Key Takeaways: 1. Focal HIFU treatment for localized PCa shows excellent functional outcomes, with half of the patients remaining cancer-free after 3 years. 2. Whole-gland treatment was avoided in 81% of patients. 3. Early follow-up biopsies are crucial to change or continue the treatment modality at the right time. 4. The use of MRI and PSA in detecting PCa recurrence is uncertain, and other diagnostic methods may be needed. 5. A significant decrease in PCa-related anxiety was observed among the patients.