#1472

Oncological and functional outcome of repeat irreversible electroporation for recurrent prostate cancer after primary electroporation

D. Feng¹, M. Scheltema¹, B. Geboers¹, S. Agrawal¹, P. Stricker¹

¹St. Vincent's Prostate Cancer Research Centre, Sydney, Australia

Introduction:

As focal therapy becomes more common for localised prostate cancer, the question arises: how do we treat recurrences following focal therapy failure? One option is to deliver a second treatment if the recurrence is localised. This study aims to evaluate the success of a second irreversible electroporation treatment after failure of primary irreversible electroporation.

Material and methods:

All patients that underwent redo IRE in the period between February 2013 and February 2024 with a minimum 12 months of follow-up were analysed. Follow-up included 6-month magnetic resonance imaging (MRI) and standardised transperineal saturation template ± targeted biopsies at 12 months, and further biopsies in the case of clinical suspicion on serial imaging and/or prostate-specific antigen (PSA) levels. Failure-free survival (FFS) was defined as no progression to radical treatment.

Results:

A total of 36 patients were analysed. 44.4% (16/36) had a clinically significant recurrence (ISUP 2 or greater). Of those patients 8.3% (3/36) were suitable for active surveillance, 5.6% had a third IRE treatment (2/36), 16.7% (6/36) underwent salvage radical prostatectomy, and 13.9% (5/36) underwent salvage radiotherapy. Overall, 63.9% achieved good local control after 2 IRE treatments (defined as not needing salvage radical treatment or >2 IRE treatments). Data on functional outcomes including continence and erectile function are currently being analysed.