Treatment of prostate cancer by high-intensity ultrasound ablation and radical prostatectomy: a comparative analysis of long-term oncological results.

Introduction. To compare oncological efficacy of long-term follow-up of high-intensity focused ultrasound ablation (HIFU) and radical prostatectomy (RP) in the treatment of patients with prostate cancer. Materials and methods. A comparative retrospective analysis included the results of treatment of 150 patients who underwent RP with 194 patients who received HIFU therapy in the period from 2008 to 2010 in the Samara Regional Clinical Oncology Center. To compare the oncological efficacy of both treatments, overall survival, cancer-specific survival, and recurrence-free survival were assessed. Biochemical recurrence was diagnosed based on ASTRO/Phoenix criteria. Statistical analysis used a one-dimensional logarithmic rank test, the Kaplan-Meier method. Results. The mean follow-up time in the RP and HIFU groups were 14,5 and 15,2 years, respectively. The 15-year overall, cancer-specific, and disease-free survival rates were 28,3%, 77,7%, 53,7% in the RP group and 48,0%, 79,4%, 69,8% in the HIFU group, respectively. Prognostic factors were PSA level before treatment, Gleason score. The results of HIFU therapy compared with RP demonstrated comparable cancer-specific and disease-free survival rates. Conclusion. HIFU therapy may be an alternative treatment for patients with PCa low and intermediate risk progression according to D'Amico. Patients with high-risk progression should be informed about possible repeat HIFU sessions and/or adjuvant treatment. In long-term follow-up, HIFU therapy compared to RP has shown a higher overall survival with comparable values of cancer-specific and relapse-free survival in the treatment of patients with prostate cancer.