Bipolar radiofrequency device boasts efficacy in prostate cancer treatment

Focal therapy of significant localized prostate cancer associated with a magnetic resonance imaging (MRI) lesion using bipolar radiofrequency appears effective in ablating cancer, with low rates of genitourinary and rectal side effects, according to a study.

The investigators recruited treatment-naïve patients with a single focus of significant localized prostate cancer (Gleason 7 or 4 mm or more of Gleason 6) concordant with a lesion visible on multiparametric MRI. The intervention involved focal ablation with a bipolar radiofrequency system (Encage) encompassing the lesion and a predefined margin using nonrigid MRI-ultrasound fusion.

The proportion of men without significant localized disease on biopsy at 6 months was the primary outcome. Trial follow-up consisted of serum prostate-specific antigen, multiparametric MRI at 1 week, and 6 and 12 months postablation. The investigators used validated patient-reported outcome measures for urinary, erectile and bowel functions, and adverse events monitoring system. Analyses were conducted on a per-protocol basis.

Twenty-one patients were identified, of whom 20 received the intervention. Their median age was 66 years (interquartile range [IQR], 63–69) and preoperative median prostate-specific antigen 7.9 ng/ml (IQR, 5.3–9.6). Eighteen patients (90 percent) had Gleason 7 disease with median maximum cancer size of 7 mm (IQR, 5­10), for a median of 2.8 cc multiparametric MRI lesions (IQR, 1.4–4.8).

Targeted biopsy of the treated area (median number of cores, 6; IQR, 5–8) exhibited no significant localized prostate cancer in 16 men (80 percent), concordant with multiparametric MRI. In addition, patient-reported outcome measures analysis revealed a low profile of side effects; no serious adverse events were reported.