title: Transrectal high-intensity focused ultrasound for treatment of localized prostate cancer.
abstract: OBJECTIVE
  To assess the long-term outcomes of transrectal high-intensity focused ultrasound (HIFU) for patients with localized prostate cancer.
  
  
  METHODS
  From May 2003 to present, 137 consecutive patients with T1-2 prostate cancer were treated using the Sonablate 500 and then followed for more than 12 months after their last HIFU treatment. A prostate biopsy was routinely carried out at 6 months and serum prostate-specific antigen (PSA) was measured every 3 months after HIFU. Oncological outcomes as well as treatment-related complications were assessed. Disease-free survival (DFS) was judged using the Phoenix definition (PSA nadir + 2 ng/mL), negative histological findings and no local or distant metastasis.
  
  
  RESULTS
  The median follow up after HIFU was 36 months (range 12-84 months). No patients received adjuvant therapy during this period. The PSA nadir occurred at 2 months after HIFU and the median level was 0.07 ng/mL (0.01-2.01 ng/mL). Of the 133 patients who underwent prostate biopsy or transurethral resection of the prostate at 6 months or later after HIFU, six were positive for cancer cells (4.5%). There were no major postoperative complications, but urge incontinence (16 cases) and dysuria (33 cases) occurred after removal of the urethral catheter. The 5-year DFS rate was 78% based on these criteria, and 91%, 81% and 62% in the low-, intermediate- and high-risk group, respectively.
  
  
  CONCLUSIONS
  HIFU represents an effective, repeatable and minimally invasive treatment. It is particularly effective for low- and intermediate-risk patients, and it should be considered as an option for localized prostate cancer.
authors: Department of Urology, Takanobashi Central Hospital, Hiroshima, Japan. yoji_inoue69@yahoo.co.jp
authors: Yoji
authors: Y
authors: Inoue
authors: Keisuke
authors: K
authors: Goto
authors: Tetsutaro
authors: T
authors: Hayashi
authors: Mutsuo
authors: M
authors: Hayashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D003251:Constriction, Pathologic / Q000209:etiology / Q000473:pathology; D018572:Disease-Free Survival; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D036761:Ultrasound, High-Intensity Focused, Transrectal / Q000009:adverse effects; D014521:Urethra / Q000473:pathology; D014555:Urination Disorders / Q000209:etiology
chemical_list: D017430:Prostate-Specific Antigen