Prostate Cancer Outcomes Good with HIFU

High-intensity focused ultrasound (HIFU) is a potentially effective treatment of localized prostate cancer (PCa) that is associated with a low PCa-specific mortality rate, according to researchers. It also is associated with a high metastasis-free survival rate (MFSR) at 10 years.

Sebastien Crouzet, MD, of Edouard Herriot Hospital, Lyon, France, and colleagues examined oncologic outcomes and morbidity among 1,002 patients who underwent whole-gland transrectal HIFU ablation for localized PCa from 1997 to 2009. Patients had a median follow-up of 6.4 years (range 0.2–13.9 years).

The 10-year PCa–specific survival rate achieved was 97%. The 10-year PCa–specific survival rates were 99%, 98%, and 94% for low-, intermediate-, and high-risk patients, respectively, Dr. Crouzet's team reported online ahead of print in European Urology.

The eight-year biochemical-free survival rates, using the Phoenix definition, were 76%, 63%, and 57% for low-, intermediate, and high-risk patients. The 10-year MFSR was 94%.

Sixty percent of patients had one HIFU session, 38% had two sessions, and 2% had three sessions.

With respect to salvage therapies, 13.8% of patients underwent external-beam radiation therapy (EBRT), 9.7% underwent EBRT plus androgen deprivation therapy (ADT), and 12.1% had ADT alone.

The median nadir PSA level was 0.14 ng/mL, with 63% of patients reaching a nadir PSA of 0.3 ng/mL or less. The frequency of severe incontinence and bladder outlet obstruction decreased with refinement in the technology from 6.4% and 34.9% to 3.1% and 5.9%, respectively. The investigators pointed out study limitations. It was a single arm study with no comparison group, and there were surgical protocol changes during the study. In addition, ADT was used to downsize the prostate in 39% of patients.

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