High-intensity focused ultrasound therapy for the treatment of prostate cancer: Medium-term experience

Abstract Introduction The treatment of localized prostate cancer seeks to minimize the impact on sexual function and urinary continence. In this respect, therapy with high-intensity focused ultrasound offers important results. We present our experience with this technique in 2 Spanish centers. Material and methods We conducted a retrospective review of 75 patients with localized prostate cancer treated with high-intensity focused ultrasound between March 2007 and July 2016. The oncological results and perioperative complications were assessed, as well as the impact on sexual function and continence. Results A total of 67 patients were analyzed. The mean follow-up was 7.2 years. The PSA nadir was 0.2 ng/ml (0–3), 24 patients (35.5%) presented biochemical recurrence, and 18 underwent a further biopsy, with 10 cases (55.5%) presenting disease recurrence. The overall biochemical relapse-free survival at 5 and 8 years was 93.2 and 80.5%, respectively. The cancer-specific survival at 5 and 8 years was 96% in both cases. In the postoperative period, 50 patients (74.6%) were continent, 16 (23.9%) reported mild incontinence, and one (1.5%) reported moderate incontinence. The median International Index of Erectile Function-5 before and after the surgery was 17 (5–25) and 16 (2–23) points, respectively. Nine patients reported de novo erectile dysfunction (13.5%). Conclusion High-intensity focused ultrasound appears to be a safe alternative for the treatment of localized prostate cancer, especially for low-risk localized prostate cancer. In our experience, this technique offers advantages in preserving urinary continence, and the medium-term oncological results are encouraging. Given the natural progression of prostate cancer, long-term studies with a larger number of cases are needed to corroborate these results.