{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T23:19:08Z","timestamp":1775690348826,"version":"3.50.1"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aktuelle Urol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title>\n                  <jats:p>Die fokale Therapie des lokal begrenzten Prostatakarzinoms hat sich zu einer pr\u00e4zisionsorientierten Alternative zu Ganzdr\u00fcsenverfahren entwickelt. Sie zielt darauf ab, klinisch signifikante Tumorherde gezielt zu zerst\u00f6ren und gleichzeitig die umgebenden Strukturen zu schonen, die f\u00fcr Harnkontinenz und Sexualfunktion entscheidend sind. Die irreversible Elektroporation ist eine relativ neue und zunehmend untersuchte fokale Therapieform. Durch kurze Hochspannungsimpulse erzeugt die irreversible Elektroporation permanente Nanoporen in Zellmembranen und l\u00f6st den Zelltod \u00fcberwiegend \u00fcber nicht-thermische Mechanismen aus. Dieser theoretische Vorteil \u2013 eine Gewebeablation bei relativer Schonung der kollagenreichen extrazellul\u00e4ren Architektur \u2013 hat das Interesse an der irreversiblen Elektroporation insbesondere f\u00fcr Tumoren in der N\u00e4he empfindlicher Strukturen wie der neurovaskul\u00e4ren B\u00fcndel, des urethralen Sphinkterkomplexes und der Rektumwand verst\u00e4rkt. In dieser \u00dcbersichtsarbeit stellen wir zentrale prozedurale und technische Aspekte dar und fassen die klinische Evidenz zur irreversiblen Elektroporation beim lokalisierten Prostatakarzinom zusammen. \u00dcber prospektive und retrospektive Fallserien hinweg sind die fr\u00fchen und mittelfristigen onkologischen Signale insgesamt ermutigend; Rezidivmuster und der Bedarf an Nachbehandlungen variieren jedoch zwischen den Kohorten und abh\u00e4ngig von den jeweiligen Nachsorgeprotokollen. Funktionell zeigen sich konsistent exzellente Ergebnisse: Die Kontinenz bleibt bei der \u00fcberwiegenden Mehrheit der Patienten erhalten und auch die Potenzerhaltung ist oft hoch, typischerweise im Bereich von etwa 75\u201395% bei M\u00e4nnern, die vor der Behandlung potent waren. Trotz dieser vielversprechenden Ergebnisse ist eine breite Integration in die Routineversorgung bislang durch den Mangel an belastbaren Langzeitendpunkten und das Fehlen randomisierter Vergleiche mit aktuellen Standards wie radikaler Prostatektomie, Radiotherapie oder risikoadaptierter aktiver \u00dcberwachung begrenzt. Obwohl prospektive Vergleichsstudien \u00e4u\u00dferst anspruchsvoll sind (sie erfordern gro\u00dfe Fallzahlen, lange Nachbeobachtungszeiten und eine sorgf\u00e4ltige Endpunktdefinition) sind sie entscheidend, um die Rolle der IRE in Therapiealgorithmen zu kl\u00e4ren, die Patientenselektion zu optimieren, Nachsorge- und Salvage-Strategien zu standardisieren und letztlich eine dauerhafte Tumorkontrolle bei anhaltendem funktionellem Nutzen zu best\u00e4tigen.<\/jats:p>","DOI":"10.1055\/a-2821-6685","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T22:32:21Z","timestamp":1775687541000},"page":"184-190","source":"Crossref","is-referenced-by-count":0,"title":["Bildgef\u00fchrte irreversible Elektroporation zur Behandlung des lokal begrenzten Prostatakarzinoms"],"prefix":"10.1055","volume":"57","author":[{"given":"Federico","family":"Collettini","sequence":"additional","affiliation":[{"name":"Radiology, Charite Medical Faculty Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5763-689X","authenticated-orcid":false,"given":"Timo Alexander","family":"Auer","sequence":"additional","affiliation":[{"name":"Radiology, Charite Medical Faculty Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carsten","family":"Stephan","sequence":"additional","affiliation":[{"name":"Urology, Charite Medical Faculty Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Fischer","sequence":"additional","affiliation":[{"name":"Radiology, Charite Medical Faculty Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Gebauer","sequence":"additional","affiliation":[{"name":"Radiology, Charite Medical Faculty Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1460","DOI":"10.1001\/jama.2024.4011","article-title":"Prostate-Specific Antigen Screening and 15-Year Prostate Cancer Mortality: A Secondary Analysis of the CAP Randomized Clinical Trial","volume":"331","author":"RM Martin","year":"2024","journal-title":"JAMA"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1056\/EVIDoa2300018","article-title":"Patient-Reported Outcomes 12 Years after Localized Prostate Cancer Treatment","volume":"2","author":"JL Donovan","year":"2023","journal-title":"NEJM Evid"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1016\/j.eururo.2024.03.027","article-title":"EAU-EANM-ESTRO-ESUR-ISUP-SIOG Guidelines on Prostate Cancer-2024 Update. 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