Focus of the Report: This Health Technology Assessment (HTA) focuses on high-intensity focused ultrasound (HIFU) for primary treatment of localized prostate cancer (PCa).

Technology Description: HIFU is a minimally invasive treatment that ablates malignant prostatic tissue using high-intensity convergent ultrasound delivered via an endorectal probe. HIFU can involve ablation of the whole prostate gland or a part of the gland (partial gland ablation). The procedure is performed in an outpatient setting.

Controversy: Although minimally invasive locally ablative therapies for PCa, such as HIFU, may result in lower morbidity and reduce time spent in the clinical setting compared with radical prostatectomy (RP) and radiotherapy, questions remain about the long-term efficacy of HIFU for tumor control due to the lack of comparative effectiveness data. If HIFU is used as focal therapy instead of whole-gland ablation, some male patients with PCa may be undertreated if there are undetected multiple foci of the primary tumor.

Key Questions:

  • Is HIFU effective for primary treatment of localized PCa?

  • How does HIFU treatment compare with other primary treatments for localized PCa?

  • Is HIFU treatment in patients with localized PCa safe?

  • Have definitive patient selection criteria been identified for the use of HIFU as primary treatment for localized PCa?

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