Effect of focal vs extended irreversible electroporation for the ablation of localized low- or intermediate-risk prostate cancer on early oncological control: A randomized clinical trial

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dc.authorid0000-0003-0906-4417
dc.authorid0000-0002-6308-1763
dc.contributor.authorZhang, Kai
dc.contributor.authorTeoh, Jeremy
dc.contributor.authordel Pilar Laguna Pes, Maria
dc.contributor.authorDominguez-Escrig, Jose
dc.contributor.authorBarret, Eric
dc.contributor.authorRamon-Borja, Juan Casanova
dc.contributor.authorMuir, Gordon
dc.contributor.authorBohr, Julia
dc.contributor.authorPelechano Gómez, Paula
dc.contributor.authorNg, Chi-Fai
dc.contributor.authorSanchez-Salas, Rafael
dc.contributor.authorde la Rosette, Jean J. M. C. H.
dc.date.accessioned2023-04-28T11:55:29Z
dc.date.available2023-04-28T11:55:29Z
dc.date.issued2023
dc.departmentİstanbul Medipol Üniversitesi, Uluslararası Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Üroloji Ana Bilim Dalı
dc.description.abstractImportance: Focal ablative irreversible electroporation (IRE) is a therapy that treats only the area of the tumor with the aim of achieving oncological control while reducing treatment-related functional detriment. Objective: To evaluate the effect of focal vs extended IRE on early oncological control for patients with localized low- and intermediate-risk prostate cancer. Design, Setting, and Participants: In this randomized clinical trial conducted at 5 centers in Europe, men with localized low- to intermediate-risk prostate cancer were randomized to receive either focal or extended IRE ablation. Data were collected at baseline and at regular intervals after the procedure from June 2015 to January 2020, and data were analyzed from September 2021 to July 2022. Main Outcomes and Measures: Oncological outcome as indicated by presence of clinically significant prostate cancer (International Society of Urological Pathology grade ?2) on transperineal template-mapping prostate biopsy at 6 months after IRE. Descriptive measures of results from that biopsy included the number and location of positive cores. Results: A total of 51 and 55 patients underwent focal and extended IRE, respectively. Median (IQR) age was 64 years (58-67) in the focal ablation group and 64 years (57-68) in the extended ablation group. Median (IQR) follow-up time was 30 months (24-48). Clinically significant prostate cancer was detected in 9 patients (18.8%) in the focal ablation group and 7 patients (13.2%) in the extended ablation group. There was no significant difference in presence of clinically significant prostate cancer between the 2 groups. In the focal ablation group, 17 patients (35.4%) had positive cores outside of the treated area, 3 patients (6.3%) had positive cores in the treated area, and 5 patients (10.4%) had positive cores both in and outside of the treated area. In the extended group, 10 patients (18.9%) had positive cores outside of the treated area, 9 patients (17.0%) had positive cores in the treated area, and 2 patients (3.8%) had positive cores both in and outside of the treated area. Clinically significant cancer was found in the treated area in 5 of 48 patients (10.4%) in the focal ablation group and 5 of 53 patients (9.4%) in the extended ablation group. Conclusions and Relevance: This study found that focal and extended IRE ablation achieved similar oncological outcomes in men with localized low- or intermediate-risk prostate cancer. Because some patients with intermediate-risk prostate cancer are still candidates for active surveillance, focal therapy may be a promising option for those patients with a high risk of cancer progression. Trial Registration: ClinicalTrials.gov Identifier: NCT01835977.
dc.identifier.citationZhang, K., Teoh, J., del Pilar Laguna Pes, M., Dominguez-Escrig, J., Barret, E., Ramon-Borja, J. C. ... de la Rosette, J. J. M. C. H. (2023). Effect of focal vs extended irreversible electroporation for the ablation of localized low- or intermediate-risk prostate cancer on early oncological control: A randomized clinical trial. JAMA Surgery, 158(4), 343-349. https://dx.doi.org/10.1001/jamasurg.2022.7516
dc.identifier.doi10.1001/jamasurg.2022.7516
dc.identifier.endpage349
dc.identifier.issn2168-6254
dc.identifier.issn2168-6262
dc.identifier.issue4
dc.identifier.pmid36723911
dc.identifier.scopus2-s2.0-85152489877
dc.identifier.scopusqualityQ1
dc.identifier.startpage343
dc.identifier.urihttps://dx.doi.org/10.1001/jamasurg.2022.7516
dc.identifier.urihttps://hdl.handle.net/20.500.12511/10905
dc.identifier.volume158
dc.identifier.wos000926124600001en_US
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthordel Pilar Laguna Pes, Maria
dc.institutionauthorde la Rosette, Jean J. M. C. H.
dc.language.isoen
dc.publisherAmerican Medical Association
dc.relation.ispartofJAMA Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectEarly Oncological Control
dc.subjectProstate Cancer
dc.subjectExtended Irreversible Electroporation
dc.titleEffect of focal vs extended irreversible electroporation for the ablation of localized low- or intermediate-risk prostate cancer on early oncological control: A randomized clinical trial
dc.typeArticle

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