Purpose: Prostate cancer (PCa) is the second most common oncologic disease among
men. Radical treatment with curative intent provides good oncological results for PCa
survivors, although definitive therapy is associated with significant number of serious
side-effects. In modern-era of medicine tissue-sparing techniques, such as focal HIFU,
have been proposed for PCa patients in order to provide cancer control equivalent to
the standard-of-care procedures while reducing morbidities and complications. The
aim of this systematic review was to summarise the available evidence about focal
HIFU therapy as a primary treatment for localized PCa.
Material and methods: We conducted a comprehensive literature review of focal HIFU
therapy in the MEDLINE database (PROSPERO: CRD42021235581). Articles published in
the English language between 2010 and 2020 with more than 50 patients were included.
Results: Clinically significant in-field recurrence and out-of-field progression were
detected to 22% and 29% PCa patients, respectively. Higher ISUP grade group, more
positive cores at biopsy and bilateral disease were identified as the main risk factors
for disease recurrence. The most common strategy for recurrence management was
definitive therapy. Six months after focal HIFU therapy 98% of patients were totally
continent and 80% of patients retained sufficient erections for sexual intercourse.
The majority of complications presented in the early postoperative period and were
classified as low-grade.