High-intensity focused ultrasound for localized prostate cancer: ready for prime time?

High-intensity focused ultrasound (HIFU) is a noninvasive treatment that induces complete coagulative necrosis of a tumor at depth through the intact skin. We evaluated a biochemical disease-free rate, safety and morbidity for localized prostate cancer treated with HIFU. A total of 132 consecutive patients with stage T1c-2N0M0 localized prostate cancer underwent HIFU using Sonablate-500 (Focus Surgery, Indianapolis, USA). The 5-year biochemical disease-free rate in all patients was 67%. The 5-year biochemical disease-free rates for patients with a pretreatment PSA less than 10 ng/ml, 10.01 to 20.0 ng/ml, 20.01-30.0 ng/ml and more than 30.01 ng/ml were 88%, 67%, 34% and 13% (log rank test, p < 0.0001), respectively. HIFU therapy appears to be a safe, efficacious and minimally invasive therapy for patients with localized prostate cancer.