HIFU Treatment for Prostate Cancer
Introduction to HIFU Treatment
- The American Urological Association recommends that patients with high-risk prostate cancer (T3b-T4, Gleason 8-10) should not be treated with HIFU as a first-line treatment, due to its poor performance as a monotherapy, with a success rate of only 47% 1
HIFU as Primary Treatment
- For patients with localized prostate cancer, a single session of HIFU is the standard protocol, but patients with intermediate-risk disease often require multiple sessions or adjuvant treatments, with a success rate of 77% after a single session 1
HIFU as Salvage Therapy
- The European Association of Urology recommends that a single session of HIFU salvage therapy is the standard protocol for local recurrence after radiation therapy or radical prostatectomy, with a 5-year biochemical recurrence-free survival rate of 50-60% 1, 2
Common Pitfalls to Avoid
- The National Comprehensive Cancer Network advises against performing HIFU based solely on positive imaging findings, due to the 8% false-positive rate of PET-PSMA caused by post-treatment changes 1
- The European Urology Association recommends avoiding approaches that combine biopsy and focal ablation simultaneously, as histological confirmation should always precede treatment 1, 3
- The American Urological Association recommends not using the Phoenix criterion (nadir + 2 ng/mL) to define failure after HIFU, as it was validated for radiation therapy, not ablation 1, 2