Prostate cancer is one of the most common cancer types in men in Europe. We reviewed current evidence on efficacy and safety of high-intensity focused ultrasound (HIFU) as primary or salvage therapy compared to radiotherapy, active surveillance, watchful waiting, and radical prostatectomy in the treatment of low and intermediate-risk localised or locally recurrent prostate cancer.

To assess efficacy, one controlled study was evaluated that compared primary HIFU with brachytherapy (a type of radiotherapy) in the treatment of localised prostate cancer. No other controlled trials comparing primary or salvage HIFU with other treatment modalities could be identified. To assess safety, in addition to the controlled study, five prospective case series were evaluated.

The current evidence is insufficient to demonstrate the efficacy and safety of both primary and salvage HIFU compared to other interventions. On the basis of the limited evidence, the inclusion in the BMG catalogue of procedures is currently not recommended.