TY - JOUR
T1 - Median 4-year outcomes of salvage irreversible electroporation for localized radio-recurrent prostate cancer
AU - Geboers, Bart
AU - Scheltema, Matthijs J.
AU - Blazevski, Alexandar
AU - Katelaris, Athos
AU - Doan, Paul
AU - Ali, Imran
AU - Agrawal, Shikha
AU - Barreto, Daniela
AU - Matthews, Jayne
AU - Haynes, Anne-Maree
AU - Delprado, Warick
AU - Shnier, Ron
AU - Thompson, James E.
AU - Stricker, Phillip D.
N1 - Funding Information: Phillip Stricker is a paid consultant with AngioDynamics. Matthijs Scheltema received an educational grant from AngioDynamics. Bart Geboers received research funding from AngioDynamics. All other authors have no interests to declare. Funding Information: The authors acknowledge Cancer Institute NSW Grant, Ramsay Foundation, St Vincent's Prostate Cancer Centre for funding support, Shikha Agrawal‐Clinical Research Coordinator, IT Applications Group and CANSTO Database at Garvan Institute. Open access publishing facilitated by University of New South Wales, as part of the Wiley ‐ University of New South Wales agreement via the Council of Australian University Librarians. Open access publishing facilitated by University of New South Wales, as part of the Wiley ‐ University of New South Wales agreement via the Council of Australian University Librarians. Funding Information: Funding was received via a Cancer Institute NSW Grant, from the Ramsay Foundation, St Vincent's Prostate Cancer Research Centre and Angio Dynamics. The authors acknowledge Cancer Institute NSW Grant, Ramsay Foundation, St Vincent's Prostate Cancer Centre for funding support, Shikha Agrawal-Clinical Research Coordinator, IT Applications Group and CANSTO Database at Garvan Institute. Open access publishing facilitated by University of New South Wales, as part of the Wiley - University of New South Wales agreement via the Council of Australian University Librarians. Open access publishing facilitated by University of New South Wales, as part of the Wiley - University of New South Wales agreement via the Council of Australian University Librarians. Funding Information: Funding was received via a Cancer Institute NSW Grant, from the Ramsay Foundation, St Vincent's Prostate Cancer Research Centre and Angio Dynamics. Publisher Copyright: © 2023 The Authors. BJU International published by John Wiley & Sons Ltd on behalf of BJU International.
PY - 2023/6
Y1 - 2023/6
N2 - Objectives: To evaluate the safety, and short to mid-term oncological and quality-of-life (QoL) outcomes of focal irreversible electroporation (IRE) for radio-recurrent prostate cancer (PCa) at a median follow-up of 4 years. Patients and Methods: This was a single-centre series of men with biopsy-proven radio-recurrent PCa treated with IRE between December 2013 and February 2022, with a minimum follow-up of 6 months. Follow-up included magnetic resonance imaging at 6 months, and standard transperineal saturation template biopsies at 12 months. Further biopsies were guided by suspicion on serial imaging or prostate-specific antigen (PSA) levels. Validated questionnaires were used to measure functional outcomes. Significant local recurrence was defined as any International Society of Urological Pathology (ISUP) score ≥ 2 on biopsies. Progression-free survival was defined as no signs of local or systemic disease on either imaging or template biopsies, or according to the Phoenix criteria for biochemical recurrence. Results: Final analysis was performed on 74 men with radio-recurrent PCa (median age 69 years, median PSA level 5.4 ng/mL, 76% ISUP score 2/3). The median (range) follow-up was 48 (27–68) months. One rectal fistula occurred, and eight patients developed urethral sloughing that resolved with transurethral resection. Among patients who returned questionnaires (30/74, 41%), 93% (28/30) had preserved urinary continence and 23% (7/30) had sustained erectile function at 12-month follow-up. Local control was achieved in 57 patients (77%), who needed no further treatment. Biopsy diagnosed 41(55%) patients received follow up template biopsies, in-field recurrences occurred in 7% (3/41), and out-field recurrences occurred in 15% of patients (6/41). The metastasis-free survival rate was 91% (67/74), with a median (interquartile range) time to metastases of 8 (5–27) months. The Kaplan–Meier estimated 5-year progression-free survival rate was 60%. Conclusions: These short- to mid-term safety, oncological and QoL outcome data endorse results from smaller series and show the ability of salvage focal IRE to safely achieve oncological control in patients with radio-recurrent PCa.
AB - Objectives: To evaluate the safety, and short to mid-term oncological and quality-of-life (QoL) outcomes of focal irreversible electroporation (IRE) for radio-recurrent prostate cancer (PCa) at a median follow-up of 4 years. Patients and Methods: This was a single-centre series of men with biopsy-proven radio-recurrent PCa treated with IRE between December 2013 and February 2022, with a minimum follow-up of 6 months. Follow-up included magnetic resonance imaging at 6 months, and standard transperineal saturation template biopsies at 12 months. Further biopsies were guided by suspicion on serial imaging or prostate-specific antigen (PSA) levels. Validated questionnaires were used to measure functional outcomes. Significant local recurrence was defined as any International Society of Urological Pathology (ISUP) score ≥ 2 on biopsies. Progression-free survival was defined as no signs of local or systemic disease on either imaging or template biopsies, or according to the Phoenix criteria for biochemical recurrence. Results: Final analysis was performed on 74 men with radio-recurrent PCa (median age 69 years, median PSA level 5.4 ng/mL, 76% ISUP score 2/3). The median (range) follow-up was 48 (27–68) months. One rectal fistula occurred, and eight patients developed urethral sloughing that resolved with transurethral resection. Among patients who returned questionnaires (30/74, 41%), 93% (28/30) had preserved urinary continence and 23% (7/30) had sustained erectile function at 12-month follow-up. Local control was achieved in 57 patients (77%), who needed no further treatment. Biopsy diagnosed 41(55%) patients received follow up template biopsies, in-field recurrences occurred in 7% (3/41), and out-field recurrences occurred in 15% of patients (6/41). The metastasis-free survival rate was 91% (67/74), with a median (interquartile range) time to metastases of 8 (5–27) months. The Kaplan–Meier estimated 5-year progression-free survival rate was 60%. Conclusions: These short- to mid-term safety, oncological and QoL outcome data endorse results from smaller series and show the ability of salvage focal IRE to safely achieve oncological control in patients with radio-recurrent PCa.
KW - ablation
KW - focal therapy
KW - irreversible electroporation
KW - localized prostate cancer
KW - radiation failure
KW - salvage treatment
UR - http://www.scopus.com/inward/record.url?scp=85145419990&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/bju.15948
DO - https://doi.org/10.1111/bju.15948
M3 - Article
C2 - 36594205
SN - 1464-4096
VL - 131
SP - 14
EP - 22
JO - BJU international
JF - BJU international
IS - S4
ER -