Role of Focal HIFU Prostate Ablation in the Management of Unilaterally Diagnosed Low and Intermediate Risk Prostate Cancer

Abstract

This study has shown short term functional and oncological outcomes for a small cohort of patients with mainly intermediate risk and low risk prostate cancer disease treated with focal HIFU. Our patients got failure free survival rate of 88% and metastasis free rate of 98% after average follow up duration of 16 months. There were no reported incontinence cases in this cohort with a noticeable improvement in the IPSS score during the follow up. Few numbers of them got erectile dysfunction (22%) who were kept on medical treatment. It is obvious through these results and the current available medium- and long-term literature that the HIFU treatment for the localized prostate cancer has high cancer control rates in the intermediate risk group especially in ISUP grade 2 more than grade 3. On the other prospective, the functional side effects are very limited in comparison to the whole gland treatments. However, up to the current time the published literature lacks randomized trials testing the long-term outcomes of the focal therapy in general in comparison to the whole gland treatments in the localized prostate cancer. Also, the best protocol of follow up after the treatment especially the PSA follow up pattern, timing of MRI and the biopsy technique still