In this study, good cancer control in the medium term was achieved with focal high-intensity focused ultrasound (HIFU) in carefully selected patients with clinically significant prostate cancer, with six and three of ten patients having, respectively, intermediate- and high-risk cancer.

• From the HIFU Evaluation and Assessment of Treatment (HEAT) registry, 1,379 patients with ≥6 mo of follow-up were analyzed; median (interquartile range) age was 66 (60–71) yr and prostate-specific antigen was 6.9 (4.9–9.4) ng/ml with D’Amico intermediate risk in 65% (896/1,379) and high risk in 28% (386/1,379).

• Repeat focal treatment due to residual or recurrent cancer was required in 252 patients; and salvage whole-gland treatment was required in 92 patients.

• Kaplan-Meier 7-yr failure-free survival (FFS) was 69% (64–74%).

• In intermediate- and high-risk cancers, 7-year FFS was 68% and 65%, respectively.

• In 0.5% (7/1,379) of patients, occurrence of Clavien-Dindo >2 adverse events was evident.