Pilot Study to Assess Safety and Clinical Outcomes of Irreversible Electroporation for Partial Gland Ablation in Men with Prostate Cancer.
OBJECTIVE
Partial prostate gland ablation is a strategy to manage localized prostate cancer. Irreversible electroporation can ablate localized soft tissues. We describe 30 and 90-day complications and intermediate term functional outcomes in men undergoing prostate gland ablation using irreversible electroporation.


METHODS
We reviewed the charts of 25 patients with prostate cancer who underwent prostate gland ablation using irreversible electroporation as a primary procedure and who were followed for at least 6 months.


RESULTS
Median followup was 10.9 months. Grade 3 complications occurred in 2 patients including epididymitis (1) and urinary tract infection (1). Fourteen patients experienced grade 2 or lower complications, mainly transient urinary symptoms, hematuria and urinary tract infections. Of 25 patients 4 (16%) had cancer in the zone of ablation on routine followup biopsy at 6 months. Of those with normal urinary function at baseline 88% and 94% reported normal urinary function at 6 and 12 months after prostate gland ablation, respectively. By 12 months only 1 patient with normal erectile function at baseline reported new difficulty with potency and only 2 patients (8%) required a pad for urinary incontinence.


CONCLUSIONS
Prostate gland ablation with irreversible electroporation is feasible and safe in selected men with localized prostate cancer. Intermediate term urinary and erectile function outcomes appear reasonable. Irreversible electroporation is effective in the ablation of tumor bearing prostate tissue as a majority of men had no evidence of residual cancer on biopsy 6 months after prostate gland ablation.
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.
Katie S
KS
Murray
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
Behfar
B
Ehdaie
Department of Surgery, Tripler Army Medical Center, Honolulu, Hawaii.
John
J
Musser
Department of Surgical Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona.
Joseph
J
Mashni
Radiochemistry and Imaging Sciences Service, Department of Radiology and Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
Govindarajan
G
Srimathveeravalli
Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
Jeremy C
JC
Durack
Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York.
Stephen B
SB
Solomon
Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Weill Cornell Medical College, New York, New York. Electronic address: colemanj@mskcc.org.
Jonathan A
JA
Coleman
D000368:Aged; D001706:Biopsy; D018274:Electroporation / Q000379:methods*; D019160:Endosonography; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010410:Penile Erection / Q000502:physiology*; D010865:Pilot Projects; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging / Q000601:surgery*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012007:Rectum; D016896:Treatment Outcome
ablation techniques; electroporation; organ sparing treatments; quality of life