Irreversible Electroporation of Prostate Cancer an Update

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It has been known that the undertaking of radical treatment for localized prostate cancer has often been ensued by a major impact upon the quality of life of individuals who had undergone radical treatment for their localized prostate cancer, some of which include urinary incontinence and other types of voiding problems as well as erectile dysfunction. This has led to the development of focal therapy for prostate cancer, which has the objective of attaining equivalent oncology control of the problem, whilst improving upon episodes of voiding and incontinence problems as well as maintaining coital and erectile function preservation of each individual patient. Irreversible electroporation (IRE) is a new treatment option which utilises using pulsed high-voltage low-energy direct electric current for the ablation of tumour. As a non-thermal energy platform, IRE does have the advantage of sparing the peri-prostatic encompassing functional structures, including blood vessels and connective tissue. Histopathology examination outcomes pursuant to the undertaking of IRE to prostate cancer had demonstrated sharp demarcation between the ablated and non-ablated tissue, whereas thermal ablation techniques had demonstrated a transitional zone of partially damaged tissue due to insufficient temperatures for definitive ablation. An internation multi-centre study pursuant to the treatment 411 patients who had undergone treatment for prostate cancer from July 2015 up to April 2020 had concluded that: For men who are afflicted by localized prostate cancer, IRE could achieve good urinary and sexual function outcomes and a reasonable oncology result. The real-world data are consistent with earlier studies, including recently published randomized controlled studies. The long-term oncology results need further investigation and follow-up. The rate of AEs was 1.8% at 3 months after IRE and major AEs were rare. The IPSS initially had worsened but had returned to baseline level at 6 months. The IIEF-5 had worsened at 3 months and then had been maintained stable subsequently. IRE had been able to achieve a reasonable oncology outcome. The clinically significant prostate cancer rate in the repeat biopsy during 12–18 months was in 24.1%. The long-term oncology results need further investigation and follow-up. The real-world data are consistent with earlier studies including recently published randomized controlled studies.