A recent French trial conducted by Pascal Rischmann, MD, PhD, of Toulouse Academic Hospital compared the effectiveness of high-intensity focused ultrasound (HIFU) and radical prostatectomy (RP) as primary treatments for localized prostate cancer. The study demonstrated that at a follow-up of 30 months, patients treated with HIFU had a significantly higher salvage treatment-free survival rate compared to those who underwent RP. This information highlights the potential benefits of HIFU over traditional surgical methods.
The HIFI study, a non-inferiority, prospective, non-randomized study conducted across 46 centers in France, included a total of 3,328 patients. Of these patients, 1,967 were treated with HIFU, while 1,361 underwent RP. The study focused on patients with low- or intermediate-risk prostate cancer, meeting specific criteria related to PSA levels, Gleason scores, and clinical stages. Notably, patients treated with HIFU displayed better functional outcomes concerning urinary continence and erectile function in comparison to those who underwent RP.
Despite differences in patient demographics between the two treatment arms, overall survival rates were similar. Cancer-specific survival was 100% for both HIFU and RP, with no treatment-related deaths. However, patients in the HIFU arm showed a lower rate of complications compared to those in the RP arm, highlighting the safety profile of the non-invasive HIFU treatment modality.
In terms of functional outcomes, patients treated with HIFU experienced lower rates of urinary incontinence and erectile dysfunction post-treatment. This suggests that HIFU may offer a more favorable impact on patients’ quality of life following prostate cancer treatment. Additionally, International Prostate Symptom scores were within the mild range for both HIFU and RP patients, emphasizing the comparable nature of symptom severity between the two treatment modalities.
The results of this study provide valuable insights into the potential benefits of high-intensity focused ultrasound (HIFU) as a primary treatment option for localized prostate cancer. While further research and long-term follow-up are necessary to confirm these findings, the data suggest that HIFU may offer advantages in terms of functional outcomes and quality of life compared to traditional radical prostatectomy. As technology continues to advance in the field of oncology, non-invasive treatments like HIFU may play an increasingly important role in the management of prostate cancer.
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