V14-03 TRANSURETHRAL WATER VAPOR ABLATION (STEAM) TO TREAT LOCALIZED PROSTATE CANCER (INVESTIGATIONAL USE ONLY)

Abstract

You have accessJournal of UrologyProstate Oncology II & Testis Oncology & Misc. Oncology (V14)1 Sep 2021V14-03 TRANSURETHRAL WATER VAPOR ABLATION (STEAM) TO TREAT LOCALIZED PROSTATE CANCER (INVESTIGATIONAL USE ONLY) Christopher Dixon, and Christopher Warlick Christopher DixonChristopher Dixon More articles by this author , and Christopher WarlickChristopher Warlick More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002111.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Convective water vapor is a unique technology that uses the thermal energy of water vapor (steam) to ablate tissue. The objective was in vivo validation of Transurethral Vapor Ablation (TUVA) in men with clinically significant localized prostate cancer by; Group 1 - TUVA/RRP assessed by immediate whole mount sectioning, Group 2 - TUVA assessed by pre/post treatment MRI in an early feasibility trial and Both Groups by intraoperative real-time ultrasound and AE assessment. METHODS: A tabletop generator and a transurethral endoscopic delivery device, along with real-time TRUS, were used to direct water vapor into any anatomic zone of the prostate to ablate malignant prostate tissue. The procedure technique currently used, including the endoscopic and real-time ultrasound monitoring of needle deployment, advancement and vapor delivery is demonstrated. To evaluate the convective principles of TUVA, real-time ultrasound patterns of vapor delivery and 7-day post treatment gadolinium MRI images were studied. Ablation effectiveness was assessed in two independent groups. In Group 1 by whole mount sectioning immediately following TUVA / radical prostatectomy. In Group 2 by assessing pre- and 7-day post TUVA MRI nonenhancement patterns as well as PIRADSv2 resolution. Immediate safety was assessed by intraoperative inspection, gross examination of the prostate (Group 1) and immediate post op adverse events along with 7-day MRI’s (Group 2). RESULTS: Real-time ultrasound vapor patterns confirmed convective spread within the zonal anatomy and boundaries of the prostate. Real-time ultrasound during treatment demonstrated the convective principles and the ability to “see” the treatment. Collectively, whole mount sectioning along with the non-enhancing areas seen on MRI’s at 7-days demonstrated ablation to ALL anatomic zones and boundaries consistent with the unique ablation capabilities of convection. In Group 2, after one treatment session, 14/17 PIRADSv2 lesions ≥3 were no longer visible within the ablation zone on 7-day MRI. There were no serious adverse events intraoperatively or within one week of the treatment. CONCLUSIONS: Transurethral delivery of water vapor thermal energy can effectively ablate any zone of the prostate from apex to base, anterior to posterior, and laterally to the prostatic “capsule”. Early feasibility data using this investigational device are favorable. Source of Funding: Francis Medical, Maple Grove, MN © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1165-e1166 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christopher Dixon More articles by this author Christopher Warlick More articles by this author Expand All Advertisement Loading ...