Oncological and functional outcomes of focal irreversible electroporation for localised prostate cancer: a single institution series of 171 cases
4 affiliations
- 1School of Medicine, Bond University, Gold Coast, QLD Australia
- 2Wesley Hospital, Brisbane, QLD Australia
- 3Department of Medicine, University of Queensland, Brisbane, QLD Australia
- 4Department of Urology, Royal Brisbane and Women’s Hospital, Brisbane, QLD Australia
Abstract
Background: Focal irreversible electroporation (IRE) is an attractive choice for patients aiming to obtain local control of prostate cancer, while decreasing the postoperative risk of impotence and incontinence compared to whole-gland treatments.
Methods: Retrospective review of a single centre prospective database of 171 consecutive primary IRE procedures for localised prostate cancer. Primary outcomes include oncological infield and out-of-field progression. Secondary objectives include post-IRE continence and impotence.
Results: The median follow-up is 35 months (3–90 months). The median diameter of the treated lesions is 11 mm (4–24 mm). Most patients had PI-RADS 4–5 abnormalities on prostate MRI, and 25 patients (15%) had ISUP grade 4–5 cancer. Of the 135 patients with >12 months follow-up, 84 had a surveillance biopsy of whom 8.3% had significant infield persistence, with significant out-of-field cancer in 14.3%. There was no difference in the risk of infield cancer persistence regardless of the pre-IRE ISUP score (p = 0.8), or tumour location (p > 0.9). The presence of low volume out-of-field cancer at diagnosis did not increase the risk of post-IRE cancer persistence/progression (p = 0.7). The prostate PSMA PET SUVmax of ≥10 did not increase the risk of infield or out-of-field recurrence of cancer (p = 0.3). A PSAD > 0.15 did not increase the risk of infield persistence or out-of-field progression of cancer (p = 0.8). Urinary continence was maintained in 167/171 (97.6%), while erectile function was maintained in 94/112 (84%) of sexually active patients who completed questionnaires.
Conclusions: Of the patients who proceeded to post-IRE biopsy, 92% had infield ablation of clinically significant cancer with a low risk of urinary incontinence or impotence. Focal IRE of prostate cancer has promising short to medium-term outcomes and is associated with low risks of impotence and incontinence. Long-term follow-up of out-of-field progression risk is required.
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BibTeX
@article{mian2026oncological,
title = {{Oncological and functional outcomes of focal irreversible electroporation for localised prostate cancer: a single institution series of 171 cases}},
author = {Z. Mian and T. Gianduzzo and B. Kua and J. Yaxley},
journal = {Prostate Cancer and Prostatic Diseases},
year = {2026},
month = sep,
doi = {10.1038/s41391-026-01148-x},
url = {https://doi.org/10.1038/s41391-026-01148-x},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Oncological and functional outcomes of focal irreversible electroporation for localised prostate cancer: a single institution series of 171 cases
AU - Z. Mian
AU - T. Gianduzzo
AU - B. Kua
AU - J. Yaxley
PY - 2026
DA - 2026/09/01
JO - Prostate Cancer and Prostatic Diseases
DO - 10.1038/s41391-026-01148-x
UR - https://doi.org/10.1038/s41391-026-01148-x
AB - Background: Focal irreversible electroporation (IRE) is an attractive choice for patients aiming to obtain local control of prostate cancer, while decreasing the postoperative risk of impotence and incontinence compared to whole-gland treatments. Methods: Retrospective review of a single centre prospective database of 171 consecutive primary IRE procedures for localised prostate cancer. Primary outcomes include oncological infield and out-of-field progression. Secondary objectives include post-IRE continence and impotence. Results: The median follow-up is 35 months (3–90 months). The median diameter of the treated lesions is 11 mm (4–24 mm). Most patients had PI-RADS 4–5 abnormalities on prostate MRI, and 25 patients (15%) had ISUP grade 4–5 cancer. Of the 135 patients with >12 months follow-up, 84 had a surveillance biopsy of whom 8.3% had significant infield persistence, with significant out-of-field cancer in 14.3%. There was no difference in the risk of infield cancer persistence regardless of the pre-IRE ISUP score (p = 0.8), or tumour location (p > 0.9). The presence of low volume out-of-field cancer at diagnosis did not increase the risk of post-IRE cancer persistence/progression (p = 0.7). The prostate PSMA PET SUVmax of ≥10 did not increase the risk of infield or out-of-field recurrence of cancer (p = 0.3). A PSAD > 0.15 did not increase the risk of infield persistence or out-of-field progression of cancer (p = 0.8). Urinary continence was maintained in 167/171 (97.6%), while erectile function was maintained in 94/112 (84%) of sexually active patients who completed questionnaires. Conclusions: Of the patients who proceeded to post-IRE biopsy, 92% had infield ablation of clinically significant cancer with a low risk of urinary incontinence or impotence. Focal IRE of prostate cancer has promising short to medium-term outcomes and is associated with low risks of impotence and incontinence. Long-term follow-up of out-of-field progression risk is required.
SN - 1365-7852
SN - 1476-5608
ER -