5-Year Outcomes of Focal Irreversible Electroporation for Localised Prostate Cancer

What is it about?

The study evaluates the outcomes of focal irreversible electroporation (IRE) as a primary treatment for localized clinically significant prostate cancer (csPCa). The median follow-up was 60 months, with some patients nearing 10 years. The oncological outcomes were acceptable, with a durable cancer response in more than four out of five men and only 17% requiring salvage radical treatment during follow-up. The patients experienced less urinary and sexual toxicity compared to radical treatment. The study also discusses the importance of comparing outcomes of salvage radical treatments to those of primary radical treatments to determine whether oncological and/or functional outcomes are compromised.

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Why is it important?

The research is important because it evaluates the longer-term oncological and functional outcomes of focal irreversible electroporation (IRE) as a primary treatment for localized clinically significant prostate cancer (csPCa) at a median follow-up of 5 years (up to 10 years). The study provides valuable insights into the effectiveness and safety of this new treatment modality in carefully selected patients, highlighting its potential to preserve better urinary and sexual function while maintaining cancer control. Key Takeaways: 1. Focal IRE appears to be a safe and effective treatment option for carefully selected and monitored patients with localized PCa, who are willing to accept the risk of requiring salvage radical therapy as a trade-off for preserving better urinary and sexual function. 2. More than four out of five men had a durable cancer response at 5 years, such that only 17% required salvage radical treatment during follow-up. 3. Salvage radical treatment outcomes after IRE are comparable to those of previous studies of salvage radical prostatectomy (RARP) following other focal ablation modalities, such as high-intensity focused ultrasound (HIFU). 4. Oncological outcomes reported in the study for focal IRE are comparable to the 5-year outcomes following focal HIFU. 5. The study emphasizes the need for long-term follow-up and external validation of these findings to establish this new treatment paradigm as a valid treatment option.