Purpose of Technology: High-intensity focused ultrasound (HIFU) is a minimally invasive (transrectal) treatment that generates heat through sound energy to destroy tumor tissue. Sound waves produced by an ultrasonic transducer mounted on an endorectal probe penetrate the rectal wall and ablate either the entire prostate gland or focal areas containing tumor while avoiding damage to normal tissue.
Rationale: The goals of the minimally invasive therapy ultrasound-guided HIFU for salvage treatment in patients with localized recurrence of prostate cancer after external beam radiotherapy (EBRT) or radical prostatectomy (RP) are to use focused ultrasound waves to thermally ablate the entire prostate gland or the cancer-containing part of the gland and achieve complete tumor control to improve survival.
Controversy: Locally ablative therapies such as HIFU may have lower morbidity compared with other salvage procedures for recurrent prostate cancer; however, questions remain about its long-term efficacy for local and distant tumor control and survival.
- Does salvage HIFU provide effective local tumor control, acceptable rates of remission, and long-term, disease-free survival in patients with recurrent prostate cancer following failure of EBRT or RP?
- Does salvage HIFU provide acceptable outcomes with regard to urinary function, prostate symptoms, and sexual function?
- How does salvage HIFU compare with other salvage treatment options for recurrent prostate cancer?
- Is salvage HIFU safe, and what are the related complications?
- Have definitive patient selection criteria been established for salvage HIFU treatment for recurrent prostate cancer?
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