Irreversible electroporation (IRE) is a novel technique to treat localized prostate cancer with the aim of achieving oncological control while reducing related side effects. We present the outcomes of localized prostate cancer treated with focal IRE ablation versus hemi-ablation from a retrospective study.

Men with histologically confirmed prostate cancer were recruited to receive focal IRE ablation or hemi-ablation. All the patients were proposed for transperineal template mapping prostate biopsy at 1-year post-IRE ablation. The functional outcomes were measured by the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF) questionnaires.

106 patients were recruited in this study. The median follow-up time was 24 months (IQR 15-36). 94 patients underwent repeat prostate biopsy at 12-month after IRE. Persistent tumor was detected 75% in the focal ablation group and 31% in the hemi-ablation group (p<0.001). Clinically significant prostate cancer (Gleason≥3+4) was detected 27.8% in the focal ablation group and 8.6% in the hemi-ablation group (p=0.003). There was no significant difference between the two group in terms of IPSS and IIEF in each of follow-up time point.

For men with localized prostate cancer, hemi-IRE ablation treatment displayed better oncological control than focal ablation without compromising on functional or sexual outcomes.