Background: Irreversible electroporation (IRE) is a novel ablative treatment modality for localized prostate cancer and aims at achieving oncological control while minimizing the related side effects. We present the functional and oncological outcomes of focal IRE ablation versus hemi-ablation from a single-center patient series.Methods: Men with histologically confirmed low–intermediate risk prostate cancer received focal IRE ablation or hemi-ablation. All the patients were recommended an MRI-targeted fusion biopsy plus systematic biopsy at 1 year post-IRE ablation. The functional outcomes were measured by the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) questionnaires.Results: In total, 106 patients were recruited in this study. The median follow-up time was 24 months (IQR 15–36). Overall, 94 patients underwent repeat prostate biopsy at 12 months after IRE. Persistent tumor was detected in 72.2% in the focal ablation group and in 31% in the hemi-ablation group (p< 0.001). Clinically significant prostate cancer (Gleason ≥ 3 + 4) was detected in 25% in the focal ablation group and in 8.6% in the hemi-ablation group (p= 0.003). There was no significant difference between the two groups in terms of IPSS and IIEF at each follow-up time point.Conclusion: For men with localized low–intermediate risk prostate cancer, hemi-IRE ablation treatment displayed better oncological control than focal ablation without compromising on functional or sexual outcomes.
背景：不可逆电穿孔是一种针对局限性前列腺癌的新型消融治疗方法，旨在实现肿瘤控制的同时最大限度地减少相关副作用。本研究通过单中心患者系列数据，比较了局灶性IRE消融与半腺体消融的功能学及肿瘤学结果。 方法：经组织学确诊为低中危前列腺癌的男性患者接受局灶性IRE消融或半腺体消融治疗。所有患者均被建议在IRE消融后1年接受MRI靶向融合活检联合系统活检。功能学结果通过国际前列腺症状评分量表和国际勃起功能指数问卷进行评估。 结果：本研究共纳入106例患者，中位随访时间为24个月（四分位距15-36个月）。总体而言，94例患者在IRE术后12个月接受了重复前列腺活检。局灶消融组中72.2%的患者检测到残留肿瘤，而半腺体消融组为31%（p<0.001）。临床显著性前列腺癌（格里森评分≥3+4）在局灶消融组的检出率为25%，半腺体消融组为8.6%（p=0.003）。在各随访时间点，两组患者的IPSS和IIEF评分均无显著差异。 结论：对于局限性低中危前列腺癌患者，半腺体IRE消融治疗在保持功能学及性功能结局不受影响的前提下，较局灶消融展现出更优的肿瘤控制效果。
肿瘤(癌症)患者之家