Abstract
BACKGROUND: Prostate cancer is a prevalent condition among older males, with radical prostatectomy being the standard treatment. However, this procedure can inevitably impact urinary and sexual functions. Irreversible electroporation represents an innovative therapeutic approach that employs high-voltage electrical pulses to selectively eradicate tumor cells, potentially preserving vital normal tissue. MATERIALS AND METHODS: This follow-up study included 11 older prostate cancer patients who underwent IRE therapy from November 2021 to December 2023. The cohort was aged 66-77 years with a median preoperative PSA of 9.46 ng/mL. Based on the EAU risk groups classification, patients were divided into low (n = 4), intermediate (n = 6), and high-risk (n = 1) groups. Follow-up exams were conducted every 3 to 6 months to assess PSA levels, imaging, and urinary/sexual function. RESULTS: Postoperatively, there was a significant decline in PSA levels across all patients, with a mean nadir of 0.78 ng/mL. The cumulative clinically significant prostate cancer recurrence rate was 27.3% at 30 months. Complications included urinary issues in 3 patients (27.3%), urethral pain in 2 patients (18.2%), and sexual dysfunction in 1 patient (9.1%). CONCLUSION: This study suggests that IRE therapy is a safe and effective treatment option for older prostate cancer patients, with promising results in preserving urinary and sexual functions. However, the recurrence rate is higher than historical controls, indicating the need for further research to optimize treatment outcomes.