The correlation between the electrode configuration and histopathology of irreversible electroporation ablations in prostate cancer patients

W. van den Bos; D. M. de Bruin; R. R. Jurhill; C. D. Savci-Heijink; B. G. Muller; I. M. Varkarakis; A. Skolarikos; P. J. Zondervan; M. P. Laguna-Pes; H. Wijkstra; T. M. de Reijke; J. J. M. C. H. de la Rosette

doi:https://doi.org/10.1007/s00345-015-1661-x

The correlation between the electrode configuration and histopathology of irreversible electroporation ablations in prostate cancer patients

W. van den Bos, D. M. de Bruin, R. R. Jurhill, C. D. Savci-Heijink, B. G. Muller, I. M. Varkarakis, A. Skolarikos, P. J. Zondervan, M. P. Laguna-Pes, H. Wijkstra, T. M. de Reijke, J. J. M. C. H. de la Rosette

Research output: Contribution to journal › Article › Academic › peer-review

51 Citations (Scopus)

Abstract

Irreversible electroporation (IRE) is a novel minimally invasive therapy for prostate cancer using short electric pulses to ablate prostate tissue. The purpose of this study is to determine the IRE effects in prostate tissue and correlate electrode configuration with the histology of radical prostatectomy (RP) specimens. We hypothesize that the area within the electrode configuration is completely ablated and that the area within the electrode configuration is predictive for the ablated area after treatment. A prospective phase I/II study was conducted in 16 consecutive patients with histopathologically confirmed prostate cancer scheduled for RP. Focal or extended IRE treatment of the prostate was performed 4 weeks prior to RP. The locations of the electrodes were used to calculate the planned ablation zone. Following RP, the specimens were processed into whole-mount sections, histopathology (PA) was assessed and ablation zones were delineated. The area of the tissue alteration was determined by measuring the surface. The planned and the histological ablation zones were compared, analysed per individual patient and per protocol (focal vs. extended). All cells within the electrode configuration were completely ablated and consisted only of necrotic and fibrotic tissue without leaving any viable cells. The histological ablation zone was always larger than the electrodes configuration (2.9 times larger for the 3 electrodes configuration and 2.5 times larger for the ≥4 electrode configuration). These ablation effects extended beyond the prostatic capsule in the neurovascular bundle in 13 out of 15 cases. IRE in prostate cancer results in completely ablated, sharply demarcated lesions with a histological ablation zone beyond the electrode configuration. No skip lesions were observed within the electrode configuration. ClinicalTrials.gov Identifier: NCT01790451 https://clinicaltrials.gov/ct2/show/NCT01790451

Original language	English
Pages (from-to)	657-664
Journal	World Journal of Urology
Volume	34
Issue number	5
DOIs	https://doi.org/10.1007/s00345-015-1661-x
Publication status	Published - 2016

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van den Bos, W., de Bruin, D. M., Jurhill, R. R., Savci-Heijink, C. D., Muller, B. G., Varkarakis, I. M., Skolarikos, A., Zondervan, P. J., Laguna-Pes, M. P., Wijkstra, H., de Reijke, T. M., & de la Rosette, J. J. M. C. H. (2016). The correlation between the electrode configuration and histopathology of irreversible electroporation ablations in prostate cancer patients. World Journal of Urology, 34(5), 657-664. https://doi.org/10.1007/s00345-015-1661-x

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title = "The correlation between the electrode configuration and histopathology of irreversible electroporation ablations in prostate cancer patients",

abstract = "Irreversible electroporation (IRE) is a novel minimally invasive therapy for prostate cancer using short electric pulses to ablate prostate tissue. The purpose of this study is to determine the IRE effects in prostate tissue and correlate electrode configuration with the histology of radical prostatectomy (RP) specimens. We hypothesize that the area within the electrode configuration is completely ablated and that the area within the electrode configuration is predictive for the ablated area after treatment. A prospective phase I/II study was conducted in 16 consecutive patients with histopathologically confirmed prostate cancer scheduled for RP. Focal or extended IRE treatment of the prostate was performed 4 weeks prior to RP. The locations of the electrodes were used to calculate the planned ablation zone. Following RP, the specimens were processed into whole-mount sections, histopathology (PA) was assessed and ablation zones were delineated. The area of the tissue alteration was determined by measuring the surface. The planned and the histological ablation zones were compared, analysed per individual patient and per protocol (focal vs. extended). All cells within the electrode configuration were completely ablated and consisted only of necrotic and fibrotic tissue without leaving any viable cells. The histological ablation zone was always larger than the electrodes configuration (2.9 times larger for the 3 electrodes configuration and 2.5 times larger for the ≥4 electrode configuration). These ablation effects extended beyond the prostatic capsule in the neurovascular bundle in 13 out of 15 cases. IRE in prostate cancer results in completely ablated, sharply demarcated lesions with a histological ablation zone beyond the electrode configuration. No skip lesions were observed within the electrode configuration. ClinicalTrials.gov Identifier: NCT01790451 https://clinicaltrials.gov/ct2/show/NCT01790451",

author = "{van den Bos}, W. and {de Bruin}, {D. M.} and Jurhill, {R. R.} and Savci-Heijink, {C. D.} and Muller, {B. G.} and Varkarakis, {I. M.} and A. Skolarikos and Zondervan, {P. J.} and Laguna-Pes, {M. P.} and H. Wijkstra and {de Reijke}, {T. M.} and {de la Rosette}, {J. J. M. C. H.}",

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van den Bos, W , de Bruin, DM, Jurhill, RR, Savci-Heijink, CD, Muller, BG, Varkarakis, IM, Skolarikos, A, Zondervan, PJ, Laguna-Pes, MP, Wijkstra, H, de Reijke, TM & de la Rosette, JJMCH 2016, 'The correlation between the electrode configuration and histopathology of irreversible electroporation ablations in prostate cancer patients', World Journal of Urology, vol. 34, no. 5, pp. 657-664. https://doi.org/10.1007/s00345-015-1661-x

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T1 - The correlation between the electrode configuration and histopathology of irreversible electroporation ablations in prostate cancer patients

AU - van den Bos, W.

AU - de Bruin, D. M.

AU - Jurhill, R. R.

AU - Savci-Heijink, C. D.

AU - Muller, B. G.

AU - Varkarakis, I. M.

AU - Skolarikos, A.

AU - Zondervan, P. J.

AU - Laguna-Pes, M. P.

AU - Wijkstra, H.

AU - de Reijke, T. M.

AU - de la Rosette, J. J. M. C. H.

PY - 2016

Y1 - 2016

N2 - Irreversible electroporation (IRE) is a novel minimally invasive therapy for prostate cancer using short electric pulses to ablate prostate tissue. The purpose of this study is to determine the IRE effects in prostate tissue and correlate electrode configuration with the histology of radical prostatectomy (RP) specimens. We hypothesize that the area within the electrode configuration is completely ablated and that the area within the electrode configuration is predictive for the ablated area after treatment. A prospective phase I/II study was conducted in 16 consecutive patients with histopathologically confirmed prostate cancer scheduled for RP. Focal or extended IRE treatment of the prostate was performed 4 weeks prior to RP. The locations of the electrodes were used to calculate the planned ablation zone. Following RP, the specimens were processed into whole-mount sections, histopathology (PA) was assessed and ablation zones were delineated. The area of the tissue alteration was determined by measuring the surface. The planned and the histological ablation zones were compared, analysed per individual patient and per protocol (focal vs. extended). All cells within the electrode configuration were completely ablated and consisted only of necrotic and fibrotic tissue without leaving any viable cells. The histological ablation zone was always larger than the electrodes configuration (2.9 times larger for the 3 electrodes configuration and 2.5 times larger for the ≥4 electrode configuration). These ablation effects extended beyond the prostatic capsule in the neurovascular bundle in 13 out of 15 cases. IRE in prostate cancer results in completely ablated, sharply demarcated lesions with a histological ablation zone beyond the electrode configuration. No skip lesions were observed within the electrode configuration. ClinicalTrials.gov Identifier: NCT01790451 https://clinicaltrials.gov/ct2/show/NCT01790451

AB - Irreversible electroporation (IRE) is a novel minimally invasive therapy for prostate cancer using short electric pulses to ablate prostate tissue. The purpose of this study is to determine the IRE effects in prostate tissue and correlate electrode configuration with the histology of radical prostatectomy (RP) specimens. We hypothesize that the area within the electrode configuration is completely ablated and that the area within the electrode configuration is predictive for the ablated area after treatment. A prospective phase I/II study was conducted in 16 consecutive patients with histopathologically confirmed prostate cancer scheduled for RP. Focal or extended IRE treatment of the prostate was performed 4 weeks prior to RP. The locations of the electrodes were used to calculate the planned ablation zone. Following RP, the specimens were processed into whole-mount sections, histopathology (PA) was assessed and ablation zones were delineated. The area of the tissue alteration was determined by measuring the surface. The planned and the histological ablation zones were compared, analysed per individual patient and per protocol (focal vs. extended). All cells within the electrode configuration were completely ablated and consisted only of necrotic and fibrotic tissue without leaving any viable cells. The histological ablation zone was always larger than the electrodes configuration (2.9 times larger for the 3 electrodes configuration and 2.5 times larger for the ≥4 electrode configuration). These ablation effects extended beyond the prostatic capsule in the neurovascular bundle in 13 out of 15 cases. IRE in prostate cancer results in completely ablated, sharply demarcated lesions with a histological ablation zone beyond the electrode configuration. No skip lesions were observed within the electrode configuration. ClinicalTrials.gov Identifier: NCT01790451 https://clinicaltrials.gov/ct2/show/NCT01790451

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DO - https://doi.org/10.1007/s00345-015-1661-x

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