HIFU

Treatment success after HIFU treatment

In the meantime, HIFU can no longer be regarded as experimental, as experience is now available covering a time-span of more than 10 years and large patient series. In a multi-centre study on 140 patients with a median follow-up of 6.4 years (range 5 to 8.8 years), the biochemically recurrence-free survival rate (Phoenix criteria) after 5 years was 77%. After this period, no carcinoma tissue was found in 86.4% of patients in control biopsies of the prostate.

Furthermore, a study in our own hospital was able to show that the extent of the fall in the PSA after HIFU treatment (so-called PSA nadir) provides an indication of whether the treatment was successful or whether its failure is to be expected. If the PSA level fell to below 0.2 ng/ml, treatment failure was established in only 4.5% of the patients during a median follow-up period of 4.9 years. One clear advantage as compared with radiation therapy is the short period of time, namely 5 – 6 months, after which the lowest PSA level is reached following HIFU. After radiation therapy, this can take several years.

In another study involving 310 patients treated in our department, the average folllow-up was 6.4 years (range 3 – 11.8 years). It was possible to demonstrate that 77.7% of the patients remained without biochemical failure during the course of the study (defined according to the Stuttgart criteria). With 72% of all patients, the PSA fell after HIFU treatment to a value <0.2 ng/ml.

The Ablatherm® device has been registered in Europe since 2000. The Urological Societies of England, France and Italy officially recommend HIFU treatment as an alternative procedure within the treatment of prostate carcinoma. In the USA, an approval study of the Food and Drug Administration (FDA) is currently underway examining the application of HIFU in comparison to cryotherapy in connection with prostate carcinoma.