Irreversible Electroporation (IRE) also known as Nanoknife, is an emerging focal therapy used in the treatment of localised prostate cancer. It remains an investigational, technique with long-term oncological outcomes not yet well-established. This study assesses the initial experience from a prospectively collected database at a single institution.

From June of 2018, all men undergoing IRE at a single institution and were registered in a prospective database. Information such as pre-operative PSA, MRI, PSMA PET and biopsy findings was collected. Post-operative data including complications, PSA decrease, need for further therapy, and post-treatment biopsy was collected.

From June of 2018, 103 men underwent IRE at a single institution and were registered in a database. Mean pre-operative PSA was 6.44. 62% of men underwent IRE as a primary treatment, whilst 2% had redo, and 35% had IRE as a salvage treatment. 4.7% of men had ISUP 1 disease, whilst men ISUP 2 accounted for 60% of cases, ISUP 3 24.7%, ISUP 4 3.5% and ISUP 5.7% of cases. Our data explores rates of requiring salvage therapy, complications and long-term PSA trends.

IRE Remains a feasible treatment option for men with localised prostate cancer. However, it’s utility is limited by high rates of further treatment and unproven long-term oncological efficacy. Yet it remains a safe and valid option, particularly with men seeking to defer definitive treatment for some time. Our data provides useful insight into developing a localised IRE service, along with associated pearls and pitfalls.