Impact on genitourinary function and quality of life following focal irreversible electroporation of different prostate segments

Özet

PURPOSEWe aimed to evaluate the genitourinary function and quality of life (QoL) following the ablationof different prostate segments with irreversible electroporation (IRE) for localized prostate cancer(PCa).METHODSSixty patients who received primary focal IRE for organ-confined PCa were recruited for thisstudy. Patients were evaluated for genitourinary function and QoL per prostate segment treated(anterior vs. posterior, apex vs. base vs. apex-to-base, unilateral vs. bilateral). IRE system settingsand patient characteristics were compared between patients with preserved vs. those with impairederectile function and urinary continence. Data were prospectively collected at baseline,3, 6, and 12 months using the expanded prostate cancer index composite, American UrologicalAssociation symptom score, SF-12 physical and mental component summary surveys. Differenceover time within segments per questionnaire was evaluated using the Wilcoxon’s signed ranktest. Outcome differences between segments were assessed using covariance models. Baselinemeasurements included questionnaire scores, age, and prostate volume.RESULTSThere were no statistically significant changes over time for overall urinary (P = 0.07–0.89), bowel(P = 0.06–0.79), physical (P = 0.18–0.71) and mental (P = 0.45–0.94) QoL scores within each segment.Deterioration of sexual function scores was observed at 6 months within each segment(P = 0.001–0.16). There were no statistically significant differences in QoL scores between prostatesegments (P = 0.08–0.97). Older patients or those with poor baseline sexual function at timeof treatment were associated with a greater risk of developing erectile dysfunction.CONCLUSIONIRE is a feasible modality for all prostate segments without any significantly different effect onthe QoL outcomes. Older patients and those with poor sexual function need to be counseledregarding the risk of erectile dysfunction.