{
  "abstract": "BACKGROUND AND OBJECTIVE: Long-term outcome data for focal therapy using high-intensity focused ultrasound (HIFU) or cryotherapy for nonmetastatic prostate cancer are needed. We report 10-yr cancer control outcomes. METHODS: Patients with nonmetastatic prostate cancer who underwent primary focal HIFU or cryotherapy and had at least 6 mo follow-up were identified from the UK HIFU Evaluation and Assessment of Treatment (HEAT) and International Cryotherapy Evaluation (ICE) prospectively maintained registries. The intervention included up to two focal ablative sessions. The primary outcome was cancer-specific mortality. Secondary outcomes were all-cause mortality, metastasis, local retreatment, radical treatment, and androgen-deprivation therapy (ADT) use. KEY FINDINGS AND LIMITATIONS: A total of 3477 patients (HIFU: n = 2897; cryotherapy: n = 580) were included from 14 UK centres (2004-2024). A total of 48%, 23%, and 25% had European Association of Urology (EAU) 2025-version favourable intermediate-, unfavourable-intermediate-, and high-risk disease, respectively. Ten-yr cancer-specific mortality was 0.13% (95% confidence interval [CI] = 0.027-0.45%). Ten-yr all-cause mortality and metastases were 12% (95% CI = 8.8-15%) and 3.3% (95% CI = 2.1-4.9%), respectively. Ten-yr ADT use was 14% (95% CI = 11-17%). Ten-yr local retreatment and radical treatment were 33% (95% CI = 30-37%) and 30% (95% CI = 27-34%), respectively, on an intention-to-treat basis. In a post hoc per-protocol analysis, undertaken to estimate outcomes under stricter adherence to the two focal ablative session protocol, patients who underwent radical treatment despite being potentially eligible for a further focal ablative session were censored at the time of radical treatment; 10-yr local retreatment and radical treatment were 13% (95% CI = 11-16%) and 8.9% (95% CI = 6.9-11%), respectively. The observational study design is the main limitation. CONCLUSIONS AND CLINICAL IMPLICATIONS: Focal therapy using up to two sessions of focal HIFU or cryotherapy could be considered as a first-line treatment for well-selected patients of nonmetastatic prostate cancer alongside radical treatment. Future research priorities should include the development of a dedicated prognostic risk calculator, further prospective assessment of focal therapy for high-risk disease, and improvements in the detection and management of locally recurrent disease.",
  "abstract_shown": true,
  "affiliations": [
    "Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. Electronic address: a.light@imperial.ac.uk",
    "Radiotherapiegroep, Deventer, The Netherlands",
    "Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK",
    "Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK",
    "Department of Urology, Queen Elizabeth Hospital, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK",
    "Department of Urology, Southampton General Hospital, University Hospital Southampton NHS Foundation Trust, Southampton, UK",
    "Department of Urology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK",
    "Division of Surgery and Interventional Science, University College London, London, UK; Department of Urology, University College Hospital, University College London Hospitals NHS Foundation Trust, London, UK",
    "Department of Urology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK",
    "Department of Urology, Sunderland Royal Hospital, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, London, UK",
    "Department of Urology, Royal Surrey County Hospital, Royal Surrey NHS Foundation Trust, Guildford, UK",
    "Department of Urology, Royal United Hospital, Royal United Hospitals Bath NHS Foundation Trust, Bath, UK",
    "Department of Urology, Princess Alexandra Hospital, The Princess Alexandra Hospital NHS Trust, Harlow, UK",
    "Department of Urology, Princess Royal Hospital, University Hospitals Sussex NHS Foundation Trust, Haywards Heath, UK"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 29,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Alexander Light",
      "orcid": "0000-0001-7246-3651"
    },
    {
      "affs": [
        1
      ],
      "name": "Max Peters",
      "orcid": "0000-0002-7981-5768"
    },
    {
      "affs": [
        2
      ],
      "name": "Archana Gopalakrishnan",
      "orcid": "0000-0001-6145-5146"
    },
    {
      "affs": [
        2
      ],
      "name": "Nikhil Mayor",
      "orcid": "0000-0003-2681-2501"
    },
    {
      "affs": [
        3
      ],
      "name": "Emma Cullen",
      "orcid": "0000-0002-3332-9289"
    },
    {
      "affs": [
        2
      ],
      "name": "Ranil Johann Boaz",
      "orcid": "0000-0002-0770-3839"
    },
    {
      "affs": [
        2
      ],
      "name": "Joseph Michael Norris",
      "orcid": "0000-0003-2294-0303"
    },
    {
      "affs": [
        2
      ],
      "name": "Samuel Morris"
    },
    {
      "affs": [
        2
      ],
      "name": "Manit Arya",
      "orcid": "0000-0002-5122-6881"
    },
    {
      "affs": [
        2
      ],
      "name": "Mariana Bertoncelli Tanaka",
      "orcid": "0000-0003-4130-6519"
    },
    {
      "affs": [
        4
      ],
      "name": "Alan P Doherty",
      "orcid": "0000-0003-3444-4710"
    },
    {
      "affs": [
        5
      ],
      "name": "Tim J. Dudderidge",
      "orcid": "0000-0001-6373-3613"
    },
    {
      "affs": [
        6
      ],
      "name": "Amr Emara",
      "orcid": "0000-0001-5619-261X"
    },
    {
      "affs": [
        7
      ],
      "name": "Mark Emberton",
      "orcid": "0000-0003-4230-0338"
    },
    {
      "affs": [
        7
      ],
      "name": "Alistair Grey",
      "orcid": "0000-0001-6017-8546"
    },
    {
      "affs": [
        6
      ],
      "name": "Richard Graham Hindley",
      "orcid": "0000-0002-7568-1694"
    },
    {
      "affs": [
        8
      ],
      "name": "Marc Laniado",
      "orcid": "0000-0003-1582-4478"
    },
    {
      "affs": [
        9
      ],
      "name": "Stuart McCraken"
    },
    {
      "affs": [
        7
      ],
      "name": "Caroline M. Moore",
      "orcid": "0000-0003-0202-7912"
    },
    {
      "affs": [
        10
      ],
      "name": "Raj Nigam",
      "orcid": "0000-0003-0750-2719"
    },
    {
      "affs": [
        6
      ],
      "name": "Mohamed Essam Noureldin",
      "orcid": "0000-0001-8994-6158"
    },
    {
      "affs": [
        7
      ],
      "name": "Clément Orczyk",
      "orcid": "0000-0003-3067-2409"
    },
    {
      "affs": [
        2
      ],
      "name": "Arnas Rakauskas",
      "orcid": "0000-0002-3265-2287"
    },
    {
      "affs": [
        11
      ],
      "name": "Lucy A. M. Simmons",
      "orcid": "0000-0002-2112-6038"
    },
    {
      "affs": [
        12
      ],
      "name": "Jaspal Singh Virdi"
    },
    {
      "affs": [
        7
      ],
      "name": "John Withington",
      "orcid": "0000-0002-8250-8013"
    },
    {
      "affs": [
        13
      ],
      "name": "Paimaun Zakikhani"
    },
    {
      "affs": [
        2
      ],
      "name": "Hashim Uddin Ahmed",
      "orcid": "0000-0003-1674-6723"
    },
    {
      "affs": [
        2
      ],
      "name": "Taimur Tariq Shah",
      "orcid": "0000-0003-1642-1208"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/aky7h1h6wzydb.bib",
  "cited_by": 10,
  "doi": "10.1016/j.eururo.2026.05.007",
  "fulltext_url": null,
  "id": "aky7h1h6wzydb",
  "issns": [
    "0302-2838",
    "1421-993X",
    "1873-7560"
  ],
  "landing_url": "https://doi.org/10.1016/j.eururo.2026.05.007",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Prostate Cancer Diagnosis and Treatment"
    ],
    [
      "openalex",
      "2748|Prostate Cancer Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7167971643",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S030228382602169X/pdf",
  "pmcid": null,
  "pmid": "42431756",
  "published": "2026-07-01",
  "publisher": "Elsevier BV",
  "ris": "https://research.draconitic.com/paper/aky7h1h6wzydb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T13:26:56Z",
      "native_id": "W7167971643",
      "source": "openalex",
      "url": "https://doi.org/10.1016/j.eururo.2026.05.007"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Prostate Cancer Diagnosis and Treatment",
      "subfield": "general"
    }
  ],
  "title": "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",
  "title_text": "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",
  "type": "peer-reviewed",
  "updated_at": "2026-11-06T13:20:39Z",
  "url": "https://research.draconitic.com/paper/aky7h1h6wzydb",
  "venue": "European Urology",
  "versions": []
}