Irreversible electroporation for treating prostate cancer

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 11 sources, which was discussed by the committee. The evidence included 1 systematic review, 1 randomised controlled trial, 1 non-randomised comparative study, 1 single-arm trial and 7 case series. It is presented in the summary of key evidence section in the overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: overall survival, recurrence-free survival, metastasis-free survival, improvement in quality of life, and need for subsequent intervention.

The professional experts and the committee considered the key safety outcomes to be: pain, bleeding, infection, loss of sexual function, damage to adjacent structures, incontinence, urethral stricture and recurrence.

One patient organisation submission was received, and 101 commentaries from people who have had this procedure were discussed by the committee.

The committee noted that detection, investigation and management of prostate cancer now involves an increased use of MRI scanning.

The committee was pleased to receive a large number of patient commentaries and a submission from a patient organisation, and these supported the need for further research.

The committee was informed that using MRI and ultrasound fusion imaging may be of value in this procedure.

The committee noted that there will be an international registry which could be useful for collecting data on focal irreversible electroporation for prostate cancer, as recommended for further research (see section 1.4).

The committee was informed that this procedure is used for treating localised prostate cancer.