Oncologic outcome, side effects and comorbidity of high-intensity focused ultrasound (HIFU) for localized prostate cancer. A review

Introduction: Prostate cancer is considered one of the most important health problems. Due to the increased number of diagnosed patients and the inability to distinguish aggressive tumors, minimally-invasive procedures have become increasingly interesting. High-intensity focused ultrasound (HIFU) is an alternative option to radical surgery to treat prostate cancer. To date, however, data on side effects and comorbidities of this technique are still not conclusive.Methods and results: We reviewed the literature to concentrate on side effects and comorbidities of HIFU treatment of prostate cancer with the following key words: hifu, high intensity focused ultrasound, ultrasonic therapy, transrectal hifu, prostate ablation, side effects, comorbidities. MedLine and Embase via Ovid database were searched. Selection criteria were: English language, articles published between 2001 and 2015, case series including at least 100 participants and reported data on side effects and comorbidities. Sixteen uncontrolled studies were identified. No randomized controlled trials (RCT) were found in the literature comparing side effects and comorbidities of HIFU to other routine approaches to prostate cancer treatment.Conclusion: HIFU seems to be a promising minimally-invasive treatment for low- and intermediate-risk prostate cancer, especially for patients who are unfit for radical surgery. Prospective studies with longer follow-up periods and RCT are required to properly assess the impact of side effects and comobidities related to the HIFU technique in comparison with other therapies to treat prostate cancer.