Rosenhammer B, Ganzer R, Zeman F, et al. - Researchers contrasted the oncological long-term efficiency of whole gland high-intensity focused ultrasound (HIFU) therapy and radical prostatectomy (RP) in patients with clinically localized prostate cancer. A total of 418 individuals following open RP (1997–2004) were contrasted with 469 patients following whole gland HIFU (1997–2009) without preselection. For an inferior overall survival, cancer-specific survival (CSS) and salvage treatment-free survival (STS), HIFU therapy was an important and independent predictor. In subgroup analysis, for intermediate- and high-risk patients, HIFU gave significantly decreased CSS whereas no variation was noted in the low-risk group, intermediate-risk HIFU patients exhibited a significantly inferior STS. Hence, for low-risk patients, while whole gland HIFU offered similar long-term effectiveness, adequate cancer control for high-risk patients was more than questionable. For the subgroup of intermediate-risk patients, CSS rates appeared to be similar up to 10 years implying that HIFU could be an option for elderly people, however, a greater risk of salvage treatment should be anticipated.