Focal therapy with high-intensity focused ultrasound (HIFU) leads to high rates of 5-year survival outcomes among patients with clinically significant nonmetastatic prostate cancer (PCa), according to a study published in European Urology.1
Although PCa therapy with chemotherapy or radiotherapy are highly effective, both are associated with adverse events (AEs) including urinary incontinence, erectile dysfunction, and rectal AEs. Focal therapy targets areas of known cancer and preserves tissue, thereby potentially reducing AEs and providing better cancer control, but previous studies have been limited in scope.
For this prospective study, researchers treated 625 patients with nonmetastatic PCa with HIFU. Patients had a prostate-specific antigen (PSA) of ≤30 ng/mL. All study participants were recommended to undergoing PSA testing every 3 to 6 months, and had multiparametric magnetic resonance imaging (mpMRI) performed after 1 year and every 1 to 2 years thereafter. Increases in PSA were investigated via prostate biopsy or mpMRI followed by biopsy if results were suspicious. Functional outcomes were assessed using questionnaires, which were completed at 1 to 2, and 2 to 3 years after HIFU treatment.
After a median follow-up of 56 months, results showed that patients had a 5-year failure-free survival (FFS) rate of 99% (95% CI, 98-100) after 1 year, 92% (95% CI, 90-95) after 3 years, and 88% (95% CI, 85-91) after 5 years.
The 5-year metastasis-free survival rate was 98% (95% CI, 97–99), the cancer-specific survival rate was 100%, and overall survival was 99% (95% CI, 97–100).
Evaluations of patient questionnaires revealed that patients treated with HIFU had low AE incidences. The rates of urinary incontinence, erectile dysfunction, and rectal AEs were 2%, 15%, and 0.3% respectively.
- Guillaumier S, Peters M, Arya M, et al. A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer [published online June 27, 2018]. Eur Urol. doi: 10.1016/j.eururo.2018.06.006