Irreversible Electroporation for focal therapy on prostate cancer: Retrospective Cohort

• Grant number: 25/09059-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: August 01, 2025
• End date: July 31, 2026
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Ariê Carneiro
• Grantee: Laura Macedo de Sousa
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). São Paulo , SP, Brazil

Abstract

Introduction: Prostate cancer is the most prevalent solid neoplasm in men. Conventional approaches to the management of early-stage prostate cancer include radical prostatectomy and radiotherapy, both associated with significant adverse effects, including sexual and urinary dysfunction. Faced with these challenges, focal therapies, also known as partial therapies, including Irreversible Electroporation, have emerged as an alternative with the potential to reduce these complications. However, the literature still presents conflicting data on its oncological and functional results.Objectives: To evaluate the complication rate of partial prostate therapy with irreversible electroporation (TPP-IRE) in prostate cancer (CaP), in addition to evaluating oncological and functional outcomes and direct costs; and to compare these data with those of robotic radical prostatectomy and partial prostate therapy with High Intensity Focused Ultrasound-HIFU (TPP-HIFU).Methods: An observational, single-center, retrospective cohort study of patients undergoing Irreversible Electroporation for the treatment of localized prostate cancer will be conducted. Patients who received partial therapy between January 2023 and December 2024 and followed for 1 year after the procedure will be selected. The Clavien-Dindo classification will be used to assess complications and adverse events and will be analyzed in three distinct periods (perioperative, 30 days of treatment and after 30 days of treatment). Oncological outcomes will be analyzed by control biopsy, joint analysis of PSA dosage with magnetic resonance imaging or PET-PSMA and need for salvage treatment. Functional outcomes will be analyzed using the EPIC-CP (Expanded Prostate Cancer Index Composite for Clinical Practice) questionnaire. The comparison between the groups treated by TPP-IRE, TPP-HIFU and Robot-Assisted Radical Prostatectomy (RARP) will be made through 1:1:2 pairing, adjusting for variables such as Gleason score, preoperative serum PSA levels and clinical tumor stage.