Introduction
intermediate-risk disease, prostate cancer
ADVERSE EVENTS, DISEASE PROGRESSION, DISEASE, PROSTATE CANCER
Focal therapy (FT) for prostate cancer (PCa) gained large interest by urologists and patients in treatment of low and intermediate-risk disease with the aim to provide equivalent oncological safety while reducing adverse events (AE) due to radical treatment [Most FT are based on ablative technologies, in particular high-intensity focused ultrasound (HIFU), cryotherapy, photodynamic therapy, electroporation, and focal radiation therapy RT by brachytherapy, for example [Currently, FTs are still defined in oncological guidelines as experimental treatment options that should only be performed in the context of clinical trials due to the significant lack of robust prospective clinical trials [The main argument for HIFU is based on the index lesion theory which states that there is a pre-dominant focus of PCa causing local and systemic progression of the disease [We aimed to assess the clinical outcome of patients treated by FT using HIFU in a prospective trial using rigorous inclusion and follow-up criteria. Based on previous HIFU data, we expected to reduce the risk of disease progression using HIFU only in carefully selected patients while reducing AE compared to standard recommended therapies like RP and RT.