Histopathological Outcomes after Irreversible Electroporation for Prostate Cancer: Results of an Ablate and Resect Study

No AccessJournal of UrologyNew Technology and Techniques1 Aug 2016Histopathological Outcomes after Irreversible Electroporation for Prostate Cancer: Results of an Ablate and Resect Study W. van den Bos, R.R. Jurhill, D.M. de Bruin, C.D. Savci-Heijink, A.W. Postema, P.G.K. Wagstaff, B.G. Muller, I.M. Varkarakis, A. Skolarikos, P.J. Zondervan, M.P. Laguna Pes, T.M. de Reijke, and J.J.M.C.H. de la Rosette W. van den BosW. van den Bos Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , R.R. JurhillR.R. Jurhill Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , D.M. de BruinD.M. de Bruin Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , C.D. Savci-HeijinkC.D. Savci-Heijink Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , A.W. PostemaA.W. Postema Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , P.G.K. WagstaffP.G.K. Wagstaff Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , B.G. MullerB.G. Muller Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , I.M. VarkarakisI.M. Varkarakis 2nd Department of Urology, Athens Medical University, University of Athens, Athens, Greece , A. SkolarikosA. Skolarikos 2nd Department of Urology, Athens Medical University, University of Athens, Athens, Greece , P.J. ZondervanP.J. Zondervan Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , M.P. Laguna PesM.P. Laguna Pes Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , T.M. de ReijkeT.M. de Reijke Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands , and J.J.M.C.H. de la RosetteJ.J.M.C.H. de la Rosette Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2977AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Irreversible electroporation is a tissue ablation modality that uses high voltage electric energy to induce an increase in cell membrane permeability. This causes destabilization of the existing cellular transmembrane potential leading to cell death, due to the inability to maintain cellular homeostasis. This phase I-II study was designed to evaluate the histopathological outcomes of irreversible electroporation to prostate and surrounding tissue in radical prostatectomy specimens. Materials and Methods: Sixteen patients with prostate cancer underwent an irreversible electroporation ablation without curative intent, followed by radical prostatectomy scheduled 4 weeks later. For histopathological examination of the prostate, whole mounted tissue slices were examined by dedicated genitourinary pathologists. The borders of the ablation zone and residual tumor were outlined on the slides. Results: The irreversible electroporation ablation zones were characterized as areas of fibrosis, necrosis and loss of epithelial tissue in terms of denudation in the glandular structures. The ablation zone was well demarcated, showing trenchant delineations between viable and nonviable tissue. The ablated tissue showed mild to moderate inflammation, with atrophic cells in 1 case. The area was surrounded by hemorrhage at the location of the electrodes. No skip lesions or viable tissue was seen in the ablation zone. Fibrinoid necrosis of the neurovascular bundle was observed in 13 patients and denudation of the urothelium of the prostatic urethra was seen in 9. Conclusions: Histopathological assessment of the prostate 4 weeks after irreversible electroporation ablation showed sharply demarcated fibrotic and necrotic tissue in the ablation zone. No viable tissue was observed in the irreversible electroporation ablation zone. References 1 : Cancer Statistics, 2015. CA Cancer J Clin2015; 65: 5. Google Scholar 2 : Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening: 1986-2005. J Natl Cancer Inst2009; 101: 1325. Google Scholar 3 : Contemporary risk profile of prostate cancer in the United States. J Natl Cancer Inst2009; 101: 1280. Google Scholar 4 : Tissue ablation with irreversible electroporation. 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Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byTaneja S (2019) Re: Oncological and Quality-of-Life Outcomes following Focal Irreversible Electroporation as Primary Treatment for Localised Prostate Cancer: A Biopsy-Monitored Prospective CohortJournal of Urology, VOL. 203, NO. 2, (254-254), Online publication date: 1-Feb-2020.Stricker P and Van Leeuwen P (2019) Editorial CommentJournal of Urology, VOL. 201, NO. 6, (1142-1142), Online publication date: 1-Jun-2019.Cadeddu J (2018) Re: Focal Irreversible Electroporation as Primary Treatment for Localized Prostate CancerJournal of Urology, VOL. 200, NO. 6, (1145-1146), Online publication date: 1-Dec-2018.Valerio M, Dickinson L, Ali A, Ramachadran N, Donaldson I, Mccartan N, Freeman A, Ahmed H and Emberton M (2016) Nanoknife Electroporation Ablation Trial: A Prospective Development Study Investigating Focal Irreversible Electroporation for Localized Prostate CancerJournal of Urology, VOL. 197, NO. 3 Part 1, (647-654), Online publication date: 1-Mar-2017. Volume 196Issue 2August 2016Page: 552-559 Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordspathologyablation techniquesprostatic neoplasmselectroporationMetricsAuthor Information W. van den Bos Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author R.R. Jurhill Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author D.M. de Bruin Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands Department of Biomedical Engineering & Physics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author C.D. Savci-Heijink Department of Pathology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author A.W. Postema Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author P.G.K. Wagstaff Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author B.G. Muller Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author I.M. Varkarakis 2nd Department of Urology, Athens Medical University, University of Athens, Athens, Greece More articles by this author A. Skolarikos 2nd Department of Urology, Athens Medical University, University of Athens, Athens, Greece More articles by this author P.J. Zondervan Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author M.P. Laguna Pes Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author T.M. de Reijke Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands More articles by this author J.J.M.C.H. de la Rosette Department of Urology, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands Financial interest and/or other relationship with Boston Scientific and AngioDynamics. More articles by this author Expand All Advertisement PDF downloadLoading ...