Results and side effects of high-intensity focused ultrasound in localizedprostate cancer

At the time of diagnosis, prostate cancer is organ confined in 70% of the c ases. A quarter of these patients undergo local therapy (surgery/radiation) ; 75% risk disease progression by "watchful waiting" or systemic side effec ts through hormonal ablation. Local high-intensity focused ultrasound (HIFU ), as minimal invasive tissue coagulation (85 degreesC), ablates prostatic tissue with high precision. Since April 1996, 184 patients have undergone 2 32 sessions of transrectal HIFU therapy (average 90 min) under spinal anest hesia at 2.25/3.0 MHz, 50 W, and a penetration depth of 25 mm, The follow-u p serum prostate specific antigen (PSA) concentration, sextant biopsies, In ternational Prostate Symptom Score (IPSS), quality of life measures (QoL), and complaint registration provide the foundation for this clinical evaluat ion. Follow-up sextant biopsies tan average of 1.9) showed 80% of the patie nts to be cancer free. In men with residual cancer, the tumor mass was redu ced more than 90%, The PSA nadir in 97% was <4 ng/mL, including 61% with va lues <0.5 ng/mL, After primary HIFU, no severe side effects (fistula, secon d or third grade incontinence, rectal mucosal burns) occurred. Ail patients had a suprapubic tube (average 29 days), and 33% needed a transurethral de bris resection averaging 7 g, They were discharged within 23 hours. Accordi ng to the short-term follow-up transrectal HIFU enables minimal invasive lo cal prostate tissue ablation with high rates of negative biopsies, low PSA nadir, and low complication rate.