A large analysis has demonstrated good long-term outcomes for men who had undergone high-intensity focused ultrasound (HIFU) as a treatment for prostate cancer. Although HIFU is not available in the United States, the researchers believe their findings should elevate this investigational procedure to the status of a primary treatment option.

A team led by Roman Ganzer, MD, of the University of Regensburg in Germany, examined data from 2,552 men (mean age 70.1 years) who had undergone Ablatherm HIFU for stage T1-3 prostate cancer and who had at least one prostate-specific antigen (PSA) follow-up test after achieving a PSA nadir. Ablatherm HIFU uses an ultrasound beam to deliver intense, highly localized heat to a very small part of the prostate.

The patients had been followed for 39.6 months (range 3 to 193 months). Prior to treatment, mean PSA was 10.2 ng/mL and median Gleason sum was 6. After HIFU therapy, the median PSA nadir was 0.11 ng/mL, reached at 12.9 weeks. Overall, the majority (83%) of patients had negative biopsies for as long as 10 years posttreatment.

“HIFU provides good biochemical control through 10 years of follow-up with a mild morbidity profile,” wrote Ganzer and associates in the abstract that accompanied their presentation at the annual meeting of the American Urological Association, held May 14-19, 2011, in Washington, DC (www.aua2011.org/abstracts/printpdf.cfm?ID=1004). “These long-term outcomes represent HIFU emerging from investigational status to become a standard primary treatment option.”

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