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The study evaluated the use of focal irreversible electroporation (IRE) as the primary treatment for localized clinically significant prostate cancer (csPCa) at a median follow-up of 5 years (up to 10 years) and found that it provides acceptable local and distant oncological control with less urinary and sexual toxicity than radical treatment. Two hundred twenty-nine patients were analyzed, and the Kaplan-Meier failure-free survival rates were 91% at 3 years, 84% at 5 years, and 69% at 8 years. Metastasis-free survival was 99.6%, and PCa-specific and overall survival were 100%. Residual csPCa was found in 24% of patients during follow-up biopsy, and MRI showed a complete ablation in 82% of patients. In addition, short-term urinary continence was preserved, and erections sufficient for intercourse decreased by 13% compared to baseline. Longer-term follow-up and external validation of these findings are needed to establish focal IRE as a valid treatment option.
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