A total of 21 men were included in the study. All men had:
- Multi-parametric MR (mpMRI)-visible significant lesion concordant with trans-perineal biopsies
- Absence of clinically significant disease elsewhere
- PSA <=15ng/ml
After completion of recruitment, a total of 20 treated men were included. None were eligible for active surveillance. A total of 10 lesions were anterior and 10 posterior for a median volume of 2.7 cc at mpMRI. No significant residual disease or new cancer was found in 16/20 (80%) patients at posttreatment biopsy. Out of the 4/20 (20%) men who failed treatment, two underwent retreatment and two were put on surveillance for 4mm Gleason 6 (3+3) and 1 mm of Gleason (3+4) (when pre-treatment these lesions measured 7.5 mm Gleason (3+4) and 10mm G(3+4), respectively).
Median PSA at 12 months post RFA was 2.7 ng/mL vs 8.1ng/ml preoperatively (p<0.001). At last visit, 1 patient with apical disease, who needed urethral dilation due to a stricture showed decreased function with leakage. IPSS remained unchanged from 9.1 to 9.89 (p=0.71) and IPSS quality-of-life was unchanged as well, from 1.84 to 1.6 (p=0.6). Erectile (IIEF-15) and bowel (UCLA-EPIC) functions remained significantly stable as demonstrated by EQ-5D and the FACT-P. No serious adverse events were reported resulting from the procedure.
The authors concluded that RFA using a bipolar device (Encage®) showed promising early control of significant disease, and a low profile of genito-urinary toxicity. Further phase II multicentre trials are required before using this modality.
Presented by: Orczyk C, University College London, Division of Surgery and Interventional Sciences, London, United Kingdom
Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, twitter: @GoldbergHanan at the 2018 European Association of Urology Meeting EAU18, 16-20 March, 2018 Copenhagen, Denmark