1:18 PM, Abstract No. 268 - Disparities in the contemporary clinical management of stage Ia renal cell carcinoma: a Surveillance, Epidemiology, and End Results (SEER) study

Abstract

Purpose: To report safety outcomes of percutaneous irreversible electroporation treatment in 130 patients with prostate adenocarcinomas. Materials and Methods: 130 patients in total with prostate adenocarcinomas in various stages (T1aN0M0-T4NXM1c) underwent IRE treatments (n1⁄4139) from 5/2011 7/2014. 25 patients had history of recurrences after other treatments (5 TURPs, 8 IRE, 4 radiations, 3 HIFUs, 3 prostatectomies alone, 2 prostatectomies þ radiations). MRIs were obtained in all cases before and 10-24 hours after treatments. MRI 3dMapping-Biopsies were used to determine tumor location in 47% of cases. Clinical and/or MRIs follow-ups were obtained at 3, 7, 12, 18, 26, 36 month intervals. Retrospective analysis was performed on 103 patients, who completed at least first 3month-followup. Whole gland ablation (n1⁄423) or partial gland ablation (n1⁄480) were performed. Mean percentage of ablated prostate tissue was 64%. Treatment field also included urethra, neurovascular bundle, bladder, rectum, urethral sphincter, seminal vesicles and small bowel (n 1⁄4 93, 82, 24, 2, 12, 27, 1, respectively). Results: Only 2 of 103 patients (1.9%) needed post-procedural hospitalization (one catheter-induced infection and one rectourethral fistula): no surgical interventions were needed. Average recuperation and Foley catheterization time was 1-2 days. No pain medications above WHO level 1 required. 12 patients (11%) reported a temporary (n1⁄410, o 9 months) and complete (n1⁄42, 43 years) reduction in potency. 3 patients (3%) reported transient dysuria. 14 patients (13%) reported transient urinary retention. 12 patients (11%) developed transient incontinence (n1⁄48) or urgency (n1⁄44) after procedure. 5 patients (4%) reported dysejaculation. 3 patients (3%) reported postprocedural infection (cystitis, epididymo-orchitis, or other infection). Conclusion: IRE offers a new effective therapeutic option for treatment of prostate adenocarcinomas in various stages and improved safety profiles, favorable to other conventional treatments. Further long-term prospective studies are needed for oncological and functional outcomes.