HIFU May Be Feasible For High-Risk Prostate Cancer

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BJU Int. 2006;98:1193-1198


High-intensity focused ultrasound (HIFU) can produce good short-term outcomes in patients with high-risk prostate cancer, researchers in Italy conclude.


Vincenzo Ficarra, MD, of the University of Verona, and his colleagues studied the use of transrectal HIFU in 30 men with high-risk prostate tumors who previously had been treated with transurethral resection. In association with HIFU treatment, all men received hormonal therapy with luteinizing hormone-releasing hormone analogs.


The HIFU treatment took a median of 140 minutes. No complications were reported. At 12 months after HIFU, only three men had a PSA level greater than 0.3 ng/mL; 28 patients (93%) were continent. Seven of the 30 patients (23%) had a positive prostate biopsy.


The most common complications were UTIs (5 patients, or 16%), stenosis of the intraprostatic and membranous urethra (3 patients, or 10%), and secondary infravesical obstruction (4 patients, or 13%).


The researchers noted that the effect of HIFU—which induces coagulative necrosis and tissue destruction—on erectile function was not a relevant outcome be-cause 80% of the men had erectile dysfunction before treatment.


“The present oncological data are promising, although they must be regarded as preliminary and needing reassessment over a longer follow-up,” the authors pointed out.

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