To assess the safety, oncological and quality-of-life (QoL) outcomes of focal ablation of apical prostate cancer (PCa) lesions with irreversible electroporation (IRE).
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.
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.
Focal ablation using IRE for PCa in the distal apex appears safe and feasible with acceptable early QoL and oncologic outcomes.
World journal of urology. 2020 Jun 02 [Epub ahead of print]
Alexandar Blazevski, Amer Amin, Matthijs J Scheltema, Anjali Balakrishnan, Anne-Maree Haynes, Daniela Barreto, Thomas Cusick, James Thompson, Phillip D Stricker
St. Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia. ., St. Vincent's Prostate Cancer Centre, Darlinghurst, NSW, Australia., Garvan Institute of Medical Research and Kinghorn Cancer Centre, Darlinghurst, NSW, Australia.