PMID- 36736917
OWN - NLM
STAT- MEDLINE
DCOM- 20230411
LR  - 20230606
IS  - 1527-9995 (Electronic)
IS  - 0090-4295 (Linking)
VI  - 174
DP  - 2023 Apr
TI  - Real-World Comparative Safety and Effectiveness of Irreversible Electroporation 
      and High-Intensity Focused Ultrasound for Prostate Cancer Ablation.
PG  - 7-17
LID - S0090-4295(23)00071-7 [pii]
LID - 10.1016/j.urology.2023.01.024 [doi]
AB  - OBJECTIVES: To assess the comparative safety and effectiveness of 2 prostate 
      cancer treatment ablation modalities: irreversible electroporation (IRE) and 
      high-intensity focused ultrasound (HIFU).  METHODS: Two systematic literature 
      reviews (SLRs) and meta-analyses (MAs) on IRE and HIFU were 
      conducted in accordance with PRISMA guidelines. Searches were conducted in PubMed 
      and EMBASE. Independent reviewers assessed literature eligibility and abstracted 
      safety and effectiveness data. Oncological, safety, functional, and quality of 
      life (QOL) outcomes were examined for each technology. MAs were conducted where 
      data quality and availability allowed, using normal methods and a random/mixed 
      effects model, and quality assessments performed. RESULTS: 
      Fifty-five publications (n = 22 IRE; n = 33 HIFU) were included in the SLRs, and 
      MAs were conducted on negative in-field post-procedure biopsy, prostate-specific 
      antigen (PSA) level reduction, potency, urinary continence, and AE rate outcomes. 
      MAs revealed that IRE patients had lower mean percent PSA level reductions, 
      higher mean rates of in-field negative post-treatment biopsy, and higher rates of 
      potency maintenance than HIFU patients. Most adverse events (AEs) reported were 
      comparable and minor (Grades I, II), with urinary tract infection, dysuria, 
      hematuria, and incontinence or urgency most frequently reported. The proportion 
      of patients experiencing a severe AE (>/=Grade III) ranged from 0 to 8% after 
      IRE and HIFU. Both modalities were associated with positive functional outcomes 
      as well as maintenance of QOL after treatment. CONCLUSIONS: Both IRE and HIFU 
      were found to produce favorable effectiveness outcomes and have low complication 
      rates while minimally impacting patient urinary and erectile function and 
      maintaining overall QOL. These real-world findings can help guide clinical 
      decision making and improve disease management for patients with prostate cancer.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier Inc. All rights reserved.
FAU - Cribbs, Kristen A
AU  - Cribbs KA
AD  - Alkemi LLC, Manchester Center, VT. Electronic address: 
      Kristen.Cribbs@alkemihealth.com.
FAU - Manning, Elizabeth F
AU  - Manning EF
AD  - AngioDynamics Inc., Latham, NY.
FAU - Zhou, Joyce
AU  - Zhou J
AD  - Alkemi LLC, Manchester Center, VT.
FAU - Lahue, Betsy J
AU  - Lahue BJ
AD  - Alkemi LLC, Manchester Center, VT.
FAU - Polascik, Thomas J
AU  - Polascik TJ
AD  - Duke University School of Medicine and Duke Cancer Institute, Durham, NC.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20230202
PL  - United States
TA  - Urology
JT  - Urology
JID - 0366151
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
CIN - Urology. 2023 Apr;174:17. PMID: 37030910
MH  - Male
MH  - Humans
MH  - Prostate-Specific Antigen
MH  - Quality of Life
MH  - *Prostatic Neoplasms/surgery/pathology
MH  - Prostate/pathology
MH  - Electroporation
MH  - Treatment Outcome
MH  - *High-Intensity Focused Ultrasound Ablation
EDAT- 2023/02/04 06:00
MHDA- 2023/04/11 06:42
CRDT- 2023/02/03 19:33
PHST- 2022/09/30 00:00 [received]
PHST- 2022/12/15 00:00 [revised]
PHST- 2023/01/02 00:00 [accepted]
PHST- 2023/04/11 06:42 [medline]
PHST- 2023/02/04 06:00 [pubmed]
PHST- 2023/02/03 19:33 [entrez]
AID - S0090-4295(23)00071-7 [pii]
AID - 10.1016/j.urology.2023.01.024 [doi]
PST - ppublish
SO  - Urology. 2023 Apr;174:7-17. doi: 10.1016/j.urology.2023.01.024. Epub 2023 Feb 2.