[Irreversible electroporation (IRE) : A minimally invasive therapeutic option in prostate cancer]

Abstract

Clinical problem: Prostate cancer is one of the most common malignant diseases in older men. As such, screening and early detection are of crucial importance.

Standard treatment: The standard management of prostate cancer includes radical prostatectomy, radiation therapy, or hormonal therapy. These standard therapies yield excellent oncologic results, but also produce significant side effects. In cases of low-risk prostate cancer, these therapies might result in over-treatment; for this reason, active surveillance has been introduced. However, acceptance of this strategy varies between patients.

Treatment innovations: Irreversible electroporation is a novel non-thermal ablation technique for soft tissues. The ablation mechanism of irreversible electroporation has some theoretical advantages in the treatment of prostate cancer. It allows image-guided focal treatment of malignant prostate tissue and a potential sparing of adjacent structures, thereby theoretically resulting in a marked reduction in treatment-related side effects compared with standard management.

Practical recommendations: Although irreversible electroporation is a promising ablation technique, it should only be used in the context of clinical trials to treat prostate cancer due to the current lack of solid evidence for this new technology.

Keywords: Ablation; Active surveillance; Image-guided; Radiology; Side-effects profile.