High-intensity focused ultrasound proves worth in prostate cancer

Ablation using high-intensity focused ultrasound can effectively control some types of localized prostate cancer for five years or longer, according to a study by German researchers.

High-intensity focused ultrasound (HIFU) ablation has long been proposed for the treatment of solid tumors in several organ systems. Advocates claim the technique could offer a credible nonsurgical treatment alternative to radiotherapy, with milder side effects.

Researchers at the University of Regensburg's St. Josef Hospital, led by urologist Dr. Andreas Blana, said their latest study is the first of its kind to evaluate long-term results of HIFU treatment in patients with localized prostate cancer.

"This treatment is an excellent option for men with localized prostate cancer, and it should be part of a doctor's armory when treating the disease," Blana said.

Blana and colleagues evaluated results from 140 patients (mean age 69.1) with early or intermediate localized prostate cancer who were treated at multiple sites in Europe between 1997 and 2001. During a mean follow-up of 6.4 years, either an increase in prostate-specific antigen levels or positive biopsy sampling was considered as evidence of treatment failure.

The investigators recorded a significant percentage of cases where focused ultrasound ablation procured long-term cancer control in patients with low- or intermediate-risk localized prostate cancer. They published their findings online Nov. 5 in European Urology.

Follow-up prostate biopsies were negative in 86.4% of patients, with a five-year PSA-related failure-free survival rate of 77%. The overall disease-free rate at five and seven years was 66% and 59%, respectively.

Results confirm the long-term efficacy of HIFU in patients with localized prostate cancer. They could be considered competitive with results reported after radical prostatectomy or external-beam radiation therapy, said Dr. Vincenzo Ficarra of the University of Padua, Italy, who wrote an editorial comment in the same issue of the publication.

"Beyond the oncologic outcomes, the article by Blana et al confirmed the very promising functional data of HIFU treatments in terms of urinary continence and recovery of erectile function," Ficarra said.

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