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Sandy Srinivas, MD


High-Frequency Irreversible Electroporation for Localized Prostate Cancer

By: Cordi Craig, MS
Posted: Tuesday, August 30, 2022

Although radiotherapy and radical prostatectomy are effective treatments of localized prostate cancer, they often cause incontinence, bowel dysfunction, and sexual dysfunction. To balance positive oncologic benefits and quality of life, high-frequency electroporation (H-FIRE) may be a suitable focal therapy because it destroys cancer cells while selectively preserving surrounding nerves and blood vessels. Chuanliang Xu, PhD, of Changhai Hospital, Shanghai, and colleagues acknowledged the lack of clinical trials to support the safety and efficacy of this therapeutic strategy in an article published in JAMA Surgery.

“Future trials with larger sample sizes that compare H-FIRE directly with a thermal energy platform should be performed,” suggested the investigators.

The researchers evaluated the safety and efficacy of H-FIRE among 109 patients with low or intermediate risk of biochemical recurrence of localized and locally advanced prostate cancer from four medical centers in China. The primary endpoint was the 6-month rate of clinically significant prostate cancer.

The follow-up duration was 6 months. The median prostate-specific antigen (PSA) level was 9 ng/mL. At 6 months, the median PSA level was 1.08 ng/mL. The 6-month clinically significant prostate cancer rate was 6.0% among 100 patients who underwent biopsy (P < .001), superior to the predefined historical control rate of 20%. Prostate cancer was detected in 14 patients overall. The median International Prostate Symptom Score was 4.5, and the median International Index of Erectile Function 5 score was 2.0.

The study team reported no intraoperative complications. The overall complication rate was 37.6%, and the most common complications included elevated white blood cell levels in urine (23.9%), epididymitis (4.6%), prolonged gross hematuria (3.7%), urinary retention (2.8%), urinary tract infection (1.8%), and bladder stones (0.9%).

Disclosure: For full disclosures of the study authors, visit

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