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. 2021 Apr;39(4):1107-1114.
doi: 10.1007/s00345-020-03275-z. Epub 2020 Jun 2.

Focal ablation of apical prostate cancer lesions with irreversible electroporation (IRE)

Alexandar Blazevski  1   2   3 , Amer Amin  4   5   6 , Matthijs J Scheltema  4   5   7 , Anjali Balakrishnan  5 , Anne-Maree Haynes  5 , Daniela Barreto  5 , Thomas Cusick  4   5 , James Thompson  4   5   6 , Phillip D Stricker  4   5   6
Affiliations

Focal ablation of apical prostate cancer lesions with irreversible electroporation (IRE)

Alexandar Blazevski et al. World J Urol. 2021 Apr.

Abstract

Introduction and objective: To assess the safety, oncological and quality-of-life (QoL) outcomes of focal ablation of apical prostate cancer (PCa) lesions with irreversible electroporation (IRE).

Methods: Patients were included in the study if they had a PCa lesion within 3 mm of the apical capsule treated with IRE. The IRE procedure was performed in our institution by a single urologist. The QoL and functional data was collected prospectively from patients who provided consent using the Expanded Prostate Cancer Index Composite (EPIC). Oncological follow up included 3-month PSA levels, mpMRI at 6 months and transperineal biopsy at 1-year post treatment.

Results: A total of 50 patients had apical PCa lesions treated between February 2013 and September 2018. Median follow-up was 44 months. There were no Clavien-Dindo grade 3 events or higher. No perioperative complications were recorded. No significant difference was observed in the EPIC urinary or bowel QoL domain between baseline and 12-month post-treatment. One patient (2%) required one pad per day for urinary incontinence 12-month post-treatment. There was a small but significant decline in EPIC sexual QoL (65 at baseline and 59 at 12-month post-IRE). Of patient's potent pre-treatment, 94% remained potent after treatment. The median PSA nadir decreased by 71% (6.25-1.7 ng/mL). Only one patient (2.5%) had in-field residual disease on repeat biopsy.

Conclusion: Focal ablation using IRE for PCa in the distal apex appears safe and feasible with acceptable early QoL and oncologic outcomes.

Keywords: Apex; Apical; Focal therapy; Irreversible electroporation; Prostate; Prostate cancer.

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References

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