Therapy of localized prostate cancer with high-intensity focused ultrasound. Results and side effects

At the time of diagnosis, prostate cancer is organ confined in 70% of the c ases. Of these patients, 25% undergo local therapy (surgery/radiation),and 75% risk disease progression by "watchful waiting" or systemic side effects through hormonal ablation. Local high-intensity focused ultrasound (HIFU) for minimal invasive tissue coagulation (85 degrees) ablates prostatic tiss ue with high precision. Follow-up sextant biopsies (1.9) showed 80% of the patients to be cancer fr ee. In those cases with residual cancer,the tumor mass was reduced by more than 90%. The PSA nadir in 97% was <4 ng/ml, including 61% <0.5 ng/ml. Afte r primary HIFU, no severe side effects occurred (no fistula, no grade II/II I incontinence, no rectal mucosa burn). As auxiliary treatments, all patien ts received a suprapubic tube (29 days),and 33% needed a transurethral debr is resection (TUR 7 g). The patients were released from the hospital within 24 h after treatment. According to the short-term follow-up, transrectal HIFU enables minimal inv asive local prostate tissue ablation with high rates of negative biopsies, low PSA nadir,and low complication rate.