JU INSIGHT: Adverse Events and Quality of Life After Electroporation for Ablation of Localized Prostate Cancer
By: Jean de la Rosette, MD, PhD; Jose Dominguez-Escrig, MD; Kai Zhang, MD; Jeremy Teoh, MD; Eric Barret, MD; Juan Casanova Ramon-Borja, MD; Gordon Muir, MD; Julia Bohr, MD; Theo de Reijke, MD, PhD; Chi-Fai Ng, MD; Chi-Ho Leung, MD; Rafael Sanchez-Salas, MD; Pilar Laguna, MD | Posted on: 16 Feb 2023
de la Rosette J, Dominguez-Escrig J, Zhang K, et al. Multicenter, randomized, single-blind, 2-arm intervention study evaluating the adverse events and quality of life after irreversible electroporation for the ablation of localized low-intermediate risk prostate cancer. J Urol. 2023;209(2):347-353.
Study Need and Importance
The major complications of current prostate cancer treatments are incontinence, erectile dysfunction, bleeding, and bowel injury. Focal therapy has emerged which might reduce harms whilst retaining beneficial oncologic control. This study was designed to evaluate the effect of focal vs extended irreversible electroporation (IRE) on side effects, patient-reported quality of life, and early oncologic control for localized low-intermediate risk prostate cancer patients (see Figure)
What We Found
In this randomized multicenter clinical trial, IRE showed a good safety profile and could achieve good urinary and sexual function outcomes in men with localized low-intermediate risk prostate cancer. Rates of adverse events and urinary function outcomes were similar between the focal ablation and extended ablation groups. In the first 3-6 months, focal ablation showed superior erectile function outcomes when compared to extended ablation therapy. From 6 months onward, there was no statistical difference in the sexual function between the 2 groups. IRE could also achieve encouraging oncologic control, and there was no significant difference between focal and extended ablation.
The long-term oncologic data (eg, metastasis-free survival, overall and cancer-specific mortality) were lacking, and the treatment options of the biopsy-positive patients were limited.
Interpretation for Patient Care
Focal and extended IRE ablation had similar safety profile, urinary function, and oncologic outcomes in men with localized low-intermediate risk prostate cancer. IRE technique can provide acceptable oncologic outcomes while preserving quality of life, and may be considered for localized low-intermediate risk prostate cancer patients.