Austrian Multicenter Study Demonstrates HIFU as Effective Organ-Preserving Treatment for Early Prostate Cancer
Key Insights
A prospective multicenter Austrian study of 51 men showed that high-intensity focused ultrasound (HIFU) successfully treated early prostate cancer while preserving quality of life.
After two years, more than 94% of patients required no additional therapy, with PSA (search) levels dropping 69% after three months and remaining stable throughout follow-up.
The focal therapy approach maintained urinary and sexual function, with erectile function fully recovering within 6-12 months and exceeding baseline levels after two years.
A groundbreaking multicenter clinical study in Austria has demonstrated that high-intensity focused ultrasound (HIFU) can effectively treat early prostate cancer while preserving patients' quality of life, offering a promising alternative to conventional whole-gland treatments. The prospective phase II feasibility trial, conducted at three hospitals under the coordination of Karl Landsteiner University of Health Sciences (search) (KL Krems), represents the first coordinated evaluation of focal HIFU within Austria's hospital system.
Study Design and Patient Population
The study enrolled 51 men with newly diagnosed, localized prostate cancer of low or intermediate risk between 2021 and 2024. All participants had tumor marker PSA (search) levels ≤15 ng/mL and stage ≤T2 disease. Each patient underwent MRI-guided, lesion-specific HIFU ablation, with monitoring conducted over two years through quarterly PSA testing, MRI scans at 12 and 24 months, and follow-up biopsies.
"Instead of removing or irradiating the entire gland, we treat only the diseased part, guided by MRI and real-time ultrasound," explained Dr. Gábor Rosta and Prof. Dr. Harun Fajkovic from the Division of Urology and Andrology at the University Hospital St. Pölten (search). "Our results show that this focused approach can effectively control cancer in selected patients while significantly reducing the side effects of conventional treatments."
Impressive Treatment Outcomes
The results demonstrated remarkable efficacy with minimal side effects. After two years, more than 94% of patients required no additional therapy. Control biopsies performed one year after the procedure showed that more than 80% of patients had no viable tumor tissue remaining. PSA (search) levels dropped by 69% after three months and remained stable throughout the follow-up period.
The safety profile was equally encouraging, with adverse events being mild and transient. Approximately one-fifth of patients experienced temporary obstructive and irritative urinary symptoms, but no severe complications were observed during the study period.
Quality of Life Preservation
Functional outcomes represented a significant advantage of the focal therapy approach. Erectile function, assessed using the five-item International Index of Erectile Function (IIEF-5), initially showed a slight decline but fully recovered within 6-12 months and exceeded baseline levels after two years. Men who began treatment with good urinary function maintained it throughout the study, while those with pre-existing voiding problems experienced marked improvement. Health-related quality-of-life scores (SF-36) remained stable across all domains.
Clinical Significance and Future Directions
Until now, HIFU has been considered experimental by the European Association of Urology, primarily due to the lack of prospective data. This Austrian study provides crucial evidence supporting the therapeutic concept of focal therapy for prostate cancer. The approach destroys only the affected part of the prostate while leaving healthy tissue intact, using millimeter-precise targeting under MRI and real-time ultrasound guidance.
The findings confirm and extend earlier single-center data from Europe and North America, representing a potential paradigm shift toward organ-preserving tumor therapies. The authors emphasize that focused ultrasound can be safely integrated into clinical routine with careful patient selection and precise execution, though they highlight the need for longer follow-up and randomized trials before the method can enter official guidelines.
The study reflects Karl Landsteiner University's research mission to improve human health through interdisciplinary approaches, particularly in oncology and clinically applied innovation, advancing the vision of personalized medicine for prostate cancer treatment.