Focal Therapy of Prostate Cancer Index Lesion With Irreversible Electroporation. A Prospective Study With a Median Follow-up of 3 Years.

Autor:	Miñana López B; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Andrés Boville G; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Barbas Bernardos G; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Ancizu Marckert X; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Torres Roca M; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Labairu Huerta L; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Villacampa Aubá F; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Ramón de Fata Chillón F; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Sanz Ortega J; Pathology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Abengózar Muela M; Pathology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Gallardo Madueño G; Radiology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Benito Boíllos A; Radiology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Alcázar Peral A; Radiology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain., Díez-Caballero Alonso F; Urology Department, CUN Prostate Center, Clínica Universidad de Navarra, Madrid, Spain.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2023 Jan; Vol. 209 (1), pp. 261-270. Date of Electronic Publication: 2022 Sep 08.
DOI:	10.1097/JU.0000000000002970
Abstrakt:	Purpose: Our aim was to assess oncologic, safety, and quality of life-related outcomes of focal therapy with irreversible electroporation in men with localized prostate cancer. Materials and Methods: This was a single-center, phase II study. Inclusion Criteria: prostate cancer International Society of Urological Pathology grade 1-2, prostate specific antigen ≤15 ng/ml, ≤cT2b. Patients were selected based on multiparametric magnetic resonance imaging and transperineal systematic and targeted magnetic resonance imaging-ultrasound fusion-guided biopsy. Ablation of index lesions with safety margin was performed. Primary end point was cancer control, defined as the absence of any biopsy-proven tumor. A control transperineal biopsy was planned at 12 months and when suspected based on prostate specific antigen and/or multiparametric magnetic resonance imaging information. Quality of life was assessed using Expanded Prostate Cancer Index Composite Urinary Continence domain, International Index of Erectile Function, and International Prostate Symptom Score. Results: From November 2014 to July 2021, 41 consecutive patients were included with a median follow-up of 36 months. Thirty patients (73%) had International Society of Urological Pathology grade 1 tumors, 10 (24%) grade 2, and 1 (2.4%) grade 3. Recurrence was observed in 16 of 41 (39%) of the whole cohort, and 16 of 33 (48.4%) who underwent biopsy. In-field recurrence was detected in 5 (15%) and out-of-field in 11 (33.3%). Ten of 41 (24.6%) including 3 of 5 (60%) with in-field recurrences had significant tumors (Gleason pattern 4-5; more than 1 core or any >5 mm involved). Median recurrence-free survival was 32 months (95% CI 6.7-57.2). Twenty-six patients (63.4%) were free from salvage treatment. All patients preserved urinary continence. Potency was maintained in 91.8%. Conclusions: Irreversible electroporation can achieve satisfactory 3-year in-field tumor control with excellent quality of life results in selected patients.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu