Targeted ablation using ultrasound-guided irreversible electroporation of index tumors (TARGET Study): Prospective development study evaluating safety, patient-reported outcomes, and oncologic efficacy Journal Article
| Authors: | Fainberg, J.; Lee, T.; Vertosick, E. A.; Sivaraman, A.; Chesnut, G.; Fine, S. W.; Eastham, J.; Coleman, J.; Ehdaie, B. |
| Article Title: | Targeted ablation using ultrasound-guided irreversible electroporation of index tumors (TARGET Study): Prospective development study evaluating safety, patient-reported outcomes, and oncologic efficacy |
| Abstract: | Introduction: We studied patient-reported functional outcomes, safety, and oncologic efficacy of focal irreversible electroporation as a primary treatment for intermediate-risk prostate cancer. Methods: Between February 2015 and April 2017, 20 consecutive patients elected irreversible electroporation and underwent 22 treatments. All underwent MRI-targeted and systematic transrectal biopsies. Eligibility criteria were grade group 2/3 prostate cancer in a maximum of 2 adjacent sextant prostate sectors in 1 hemigland without extraprostatic extension on MRI. Ablation was performed with a 5-mm cancer margin. Any grade group 1 cancer outside mapped index lesion was untreated. Outcome measures were based on the Prostate Quality of Life Survey, Male Sexual Health Questionnaire, and MRI-targeted and systematic biopsies at 3 and 12 months. Results: Nineteen patients completed irreversible electroporation. One had electrocardiographic changes, and irreversible electroporation was aborted. No deterioration was detected in urinary or sexual domains (-0.2, 95% CI -1.4, 0.9, P 1⁄4 .7, and -1.9, 95% CI -10.1, 6.4, P 1⁄4 .6, respectively) or health-related quality of life (-0.2, 95% CI -1.4, 1.0, P 1⁄4 .7) at 6 months post ablation. Ejaculation volume decreased at 12 months (-1.5 points, 95% CI -2.4, -0.5, P 1⁄4 .003). At 12 months of follow-up, 14/19 patients (74%, 95% CI 49%, 91%) had no clinically significant cancer anywhere in the prostate. Radical treatmentefree survival was 79% at 2 years (95% CI 53%, 92%) and 73% at 4 years (95% CI 47%, 88%). Conclusions: Our data show promising oncologic and functional outcomes following focal irreversible electroporation treatment for carefully selected patients with intermediate-risk prostate cancer. Further research should compare irreversible electroporation with active surveillance. © 2024 by AMERICAN UROLOGICAL ASSOCIATION EDUCATION AND RESEARCH, INC. |
| Keywords: | ablation techniques; prostatic neoplasm; focal therapy; irreversible electroporation |
| Journal Title: | Urology Practice |
| Volume: | 11 |
| Issue: | 6 |
| ISSN: | 2352-0779 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2024-11-01 |
| Start Page: | 983 |
| End Page: | 990 |
| Language: | English |
| DOI: | 10.1097/upj.0000000000000666 |
| PROVIDER: | scopus |
| PMCID: | PMC11507127 |
| PUBMED: | 39196716 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Jonathan Fainberg -- Source: Scopus |
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