A major UK registry analysis has reported long-term outcomes for 3,477 patients with nonmetastatic prostate cancer treated with focal high-intensity focused ultrasound (HIFU) or cryotherapy.
The study used prospectively maintained HEAT and ICE registries and reports outcomes up to 10 years after focal therapy, including metastasis, use of androgen-deprivation therapy, local retreatment and radical treatment.
Alexander Light et al. European Urology, 2026. DOI: 10.1016/j.eururo.2026.05.007. Article accepted 20 May 2026.
Read the full PDF study Submit a HIFU suitability enquiryLong-term data are particularly important when considering focal therapy for prostate cancer. The investigators identified patients in the UK HEAT and ICE registries who had undergone primary focal HIFU or cryotherapy for nonmetastatic prostate cancer and had at least six months of follow-up.
The focal treatment strategy allowed up to two focal ablative sessions. Patients who had whole-gland, subtotal or salvage ablation, metastatic disease at treatment, or less than six months of follow-up were excluded.
The primary outcome was prostate cancer-specific mortality. Secondary outcomes included all-cause mortality, development of metastases, androgen-deprivation therapy (ADT), local retreatment and radical treatment.
Study overview based on the supplied European Urology article. The paper itself should be used for full methodology, confidence intervals, subgroup analyses and limitations.
The study is useful because it does not only report cancer spread. It also records how often patients went on to require further local focal treatment or a radical treatment such as whole-gland ablation, surgery or radiation treatment.
In the intention-to-treat analysis, the 10-year cumulative incidence was 33% for local retreatment and 30% for radical treatment.
The investigators also performed a post-hoc per-protocol analysis designed to estimate outcomes when the protocol allowing up to two focal ablative sessions was followed more strictly.
In that analysis, the 10-year cumulative incidence was 13% for local retreatment and 8.9% for radical treatment.
Focal therapy is intended to treat clinically important prostate cancer while avoiding treatment of the entire prostate where this is considered appropriate.
One of the major questions surrounding focal therapy has been whether cancer control remains acceptable over longer periods. This study contributes 10-year registry data from a large UK cohort and provides information not only on metastasis, but also on subsequent treatment requirements.
For patients considering HIFU, the results are useful as part of a broader discussion about cancer control, the possibility of repeat focal treatment and the possibility that radical treatment may still be required later.
The authors note that registry data are inherently subject to missing-data bias and right-censoring. Patient selection, treatment delivery and follow-up also varied between institutions and evolved over time.
The paper also notes that post-treatment PSA kinetics were not explored, that there is no universally accepted definition of biochemical failure after focal therapy, and that other focal therapy modalities such as irreversible electroporation were not included.
These limitations are important when interpreting long-term registry results and when comparing focal therapy with other treatment approaches.
The full paper is titled “Oncological Outcomes Following Focal HIFU and Cryotherapy for Treatment of Nonmetastatic Prostate Cancer in the United Kingdom: An Updated Analysis of 3477 Patients from the Prospective HEAT and ICE Registries.”
The article is published in European Urology and is identified by DOI 10.1016/j.eururo.2026.05.007.
Open full PDF study View publisher recordLong-term study results are one part of deciding whether focal therapy may be appropriate. The more important question for an individual patient is whether the location, grade and extent of their prostate cancer make focal HIFU a reasonable treatment option.
A/Prof Peter Royce can review PSA results, prostate MRI findings, biopsy information and relevant clinical history to assess whether HIFU should be considered.
If you have been diagnosed with localised prostate cancer, you can submit your clinical information for an initial suitability review.
Submit HIFU enquiry Who is suitable?Read how HIFU works, review who may be suitable, or submit your clinical details if you would like A/Prof Peter Royce to assess whether HIFU may be an appropriate option.
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