Both Primary and Salvage HIFU Treatments Recommended in 2014 EAU Guidelines on Prostate Cancer
In the EAU Guidelines 2014 edition, HIFU is recommended for the primary treatment of localized prostate cancer and received a “C” recommendation grade. HIFU was not previously recommended nor graded by the EAU. HIFU as a salvage therapy following failed radiation therapy was recommended in the 2014 edition with a “B” recommendation grade. In the 2013 edition, HIFU as salvage therapy was recommended as an experimental treatment option without a grade.
The EAU Guidelines aim to help improve clinical practice and are based on a formal review of all of the evidence obtained from peer-reviewed publications. Based on the EAU’s methodology, each treatment is assigned a recommendation grade, which is not a scale but rather reflects the types of studies used to evaluate the treatment and make the recommendation.
The EAU Guidelines on Prostate Cancer are a primary reference for urologists in Europe and many other countries and the primary resource used to establish standards of care for the treatment of prostate cancer. Inclusion in the treatment guidelines as a recommended therapeutic option, which is based on clinical evidence, further validates HIFU technology and the procedure as an accepted clinical practice among health authorities and urologists.
The EAU’s recommendation for HIFU both as a primary treatment and salvage therapy establishes HIFU as an emerging standard of care for prostate cancer. Having said the above, the EAU also recommends continued study and evaluation of HIFU based technologies and urological indications.
Dr. George Suarez comments: HIFU as a salvage treatment (for patients with biochemical failure after radiation therapy) recently received European approval with at Level of Evidence (number score) and Grade of Recommendation (letter score) score of 3-B respectively which means that the EAU has based its recommendation on “Evidence obtained from well-designed non-experimental studies such as comparative studies or correlation studies” and “Based on well conducted clinical studies.” This is very good news for HIFU and especially for patients requiring salvage treatments. Particularly, with the recent adverse effects that have been documented with the use of hormone therapy in the treatment of prostate cancer reoccurrence, and further acknowledged by The FDA ADVERSE WARNING statement. *
The EUA’s endorsement of HIFU as a primary treatment for localized prostate cancer is equally important in that it offers men a non-invasive curative option.
* FDA: Include warnings on risk for class of prostate cancer …