The safety and effectiveness of water vapor for ablation of prostate tissue was assessed in men with intermediate-risk localized prostate cancer (PCa).
A prospective, multi-center, single arm study (VAPOR 2) was conducted in 235 men at 26 centers across the US in men ≥50 years, with Gleason Grade Group 2 (GG2) PCa confined to a single PI-RADS 3 or 4 abnormality on multi-parametric magnetic resonance imaging (mpMRI) fusion biopsy, prostate-specific antigen (PSA) level ≤15 ng/ml, and clinical stage ≤T2c. Data presented is a pre-defined subset analysis of 110 men completing 12-month follow-up to assess only ablative efficacy and toxicity. Reported outcomes include biopsy 6-months post-treatment, PSA, prostate volume reduction, urinary/sexual function, quality-of-life questionnaires, and adverse events. The 3-year follow-up analysis will evaluate efficacy in PCa management, with 5-years total follow-up.
Median age was 65, with a median baseline PSA of 5.6 ng/mL and prostate volume of 40.7cc. On 6-month biopsy, targeted sampling of the treated region revealed benign tissue onlyin 75% and benign tissue or GG1 PCa in 91%. Regression analysis did not identify a significant baseline predictor of positive biopsy. PSA showed a median reduction of 58%, with a median 8cc reduction in prostate volume. Urinary and sexual function showed an initial decline followed by gradual recovery through 12 months. Perioperative adverse events were generally mild and resolved without sequelae, with no reports of rectal injury.
The VAPOR 2 study demonstrated effective ablation of prostate tissue in men with localized, intermediate risk PCa with low rates of procedural morbidity.
The Journal of urology. 2026 Jun 10 [Epub ahead of print]
Arvin George, Eric Giesler, Brian Mazzarella, Richard Levin, Daniel Frendl, Christopher Warlick, Robert Given, Naveen Kella, Thomas Frye, Lance Mynderse, Ali Kasraeian, Aaron Milbank, Phillippe Nabbout, Ivan Grunberger, Ardeshir Rastinehad, Michael Schwartz, James Wysock, Michael Rousseau, Marc Pliskin, Raj Satkunasivam, David Rich, Neal D Shore, Jose Moreno, Laurence Belkoff, Abhinav Sidana, Samir S Taneja
Johns Hopkins University, Baltimore, MD., Urology Austin, Austin, TX., Chesapeake Urology, Annapolis, MD., Mayo Clinic - Scottsdale, Scottsdale, AZ., University of Minnesota, Minneapolis, MN., Urology of Virginia, Virginia Beach, VA., The Urology Place, San Antonio, TX., University of Rochester, Rochester, NY., Mayo Clinic - Rochester, Rochester, MN., Kasraeian Urology, Jacksonville, FL., Minnesota Urology, Woodbury, MN., Wichita Urology, Wichita, KS., Northwell Health, North New Hyde Park, NY., New York University Langone Health, New York, NY., The Urology Group, Cincinnati, OH., Houston Methodist Research Institute, Houston, TX., Carolina Urologic Research Center, Myrtle Beach, SC., MidLantic Urology, Pottstown, PA., University of Chicago, Chicago, IL.