The authors explain in an online issue of European Urology published July 3 that HIFU treatment of the prostate works by focusing high-powered ultrasound energy, generated by a spherical transducer placed in the rectum, to produce temperatures of 85 C at the focal point. Transurethral resection of the prostate (TURP) is performed prior to HIFU treatment.
For the current study, patients were selected on the basis of clinical stage (T1-T2, N0, M0), no previous prostatectomy or radiation treatment, and no neoadjuvant hormone therapy.
Dr. Sebastien Crouzet at the Universite´ de Lyon, France, and colleagues analyzed data on 803 eligible patients after a mean follow-up of 42 months.
A mean PSA nadir of 1.0 ng/mL was reached in a mean time of 12.9 weeks after HIFU therapy. Prostate size dropped from a mean of 24.5 mL immediately after the TURP procedure, to 13.6 mL after HIFU.
Control biopsies were negative in 77.9% of patients, the team reports. “The overall and cancer-specific survival rates (CSSR) at 8 years were 89% and 99%, respectively.” The 8-year metastasis-free survival rate was 97%.
“HIFU can be repeated when necessary several months or several years after the first session and can also be followed by a salvage radiation therapy,” the investigators write. “This probably explains the excellent middle-term CSSR achieved in this multicenter study despite the presence of intermediate- and high-risk patients.”