{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:55:01Z","timestamp":1787025301451,"version":"build-2736575974"},"reference-count":34,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:00:00Z","timestamp":1764547200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prostate cancer (PCa) is a common cancer in men in developed countries. PCa treatment depends on the disease\u2019s stage; focal therapy provides an intermediate approach, with lower toxicity compared to radical prostatectomy, and better tumor control than active surveillance. We report the first retrospective analysis of prostate cancer patients treated with ECT at our institution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>A cohort of 144 men with prostate cancer who were ineligible for or refused standard therapies were included and treated with ECT. Routine follow-up included PSA tests and MRI scans, as well as toxicity and genitourinary function evaluation by means of standard questionnaires. Local response was evaluated with MRI at 3 months after treatment, following the RECIST criteria for solid tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The procedure was technically successful in all patients and was well tolerated, with mild and temporary adverse events. Urinary and erectile functions were mostly preserved. A complete response was observed in 75% of evaluated patients, a partial response in 18%, stable disease in 5%, and disease progression in 2%. Short-term response was associated with TNM stage (p &lt; 0.05), Gleason score (p = 0.0066), and pre-ECT PSA levels (p = 0.0070). During follow-up, 18 patients (13%) experienced disease progression; 1-year PFS was 88% (95% CI: 80%\u201397%) and was found to be significantly associated with tumor stage and pre-treatment PSA levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>ECT is a feasible, safe, and effective treatment for prostate cancer, with extremely low toxicity and side effects. Preliminary results suggest that it offers promising outcomes in terms of local disease control in early-stage tumors, but also in locally advanced cases where other treatments may not be viable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2025-0061","type":"journal-article","created":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T16:58:27Z","timestamp":1765904307000},"page":"597-606","source":"Crossref","is-referenced-by-count":3,"title":["Prostate cancer treatment with electrochemotherapy (ECT): safety, efficacy and clinical experience in 144 patients"],"prefix":"10.2478","volume":"59","author":[{"given":"Mara","family":"Stevanovic","sequence":"first","affiliation":[{"name":"VITUS Privatklinik , Offenbach , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Heringer","sequence":"additional","affiliation":[{"name":"VITUS Privatklinik , Offenbach , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Hjouj","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Al-Quds University , Jerusalem"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Zanasi","sequence":"additional","affiliation":[{"name":"IGEA S.p.a. Biophysics Lab. Carpi , Modena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca de","family":"Terlizzi","sequence":"additional","affiliation":[{"name":"IGEA S.p.a. Biophysics Lab. Carpi , Modena , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael K","family":"Stehling","sequence":"additional","affiliation":[{"name":"VITUS Privatklinik , Offenbach , Germany"},{"name":"Department of Medical Imaging, Al-Quds University , Jerusalem"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,12,16]]},"reference":[{"key":"2026071215564884353_j_raon-2025-0061_ref_001","doi-asserted-by":"crossref","unstructured":"Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024; 74: 229-63. doi: 10.3322\/caac.21834","DOI":"10.3322\/caac.21834"},{"key":"2026071215564884353_j_raon-2025-0061_ref_002","doi-asserted-by":"crossref","unstructured":"Gandaglia G, Leni R, Bray F, Fleshner N, Freedland SJ, Kibel A, et al. Epidemiology and prevention of prostate cancer. Eur Urol Oncol 2021; 4: 877-92. doi: 10.1016\/j.euo.2021.09.006","DOI":"10.1016\/j.euo.2021.09.006"},{"key":"2026071215564884353_j_raon-2025-0061_ref_003","doi-asserted-by":"crossref","unstructured":"Rebbeck TR, Devesa SS, Chang BL, Bunker CH, Cheng I, Cooney KA, et al. Global patterns of prostate cancer incidence, aggressiveness, and mortality in men of African descent. Prostate Cancer 2013; 2013: 560857. doi: 10.1155\/2013\/560857","DOI":"10.1155\/2013\/560857"},{"key":"2026071215564884353_j_raon-2025-0061_ref_004","doi-asserted-by":"crossref","unstructured":"Cornford P, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer \u2013 2024 update. Part I: Screening, diagnosis, and local treatment with curative intent. Eur Urol 2024; 86: 148-63. doi: 10.1016\/j. eururo.2024.03.027","DOI":"10.1016\/j.eururo.2024.03.027"},{"key":"2026071215564884353_j_raon-2025-0061_ref_005","doi-asserted-by":"crossref","unstructured":"Wilt TJ, Brawer MK, Jones KM, Barry MJ, Aronson WJ, Fox S, et al. Radical prostatectomy versus observation for localized prostate cancer. N Engl J Med 2012; 367: 203-13. doi: 10.1056\/nejmoa1113162","DOI":"10.1056\/NEJMoa1113162"},{"key":"2026071215564884353_j_raon-2025-0061_ref_006","doi-asserted-by":"crossref","unstructured":"Tilki D, van den Bergh RCN, Briers E, Van den Broeck T, Brunckhorst O, Darraugh J, et al. EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer. Part II \u2013 2024 update: Treatment of relapsing and metastatic prostate cancer. Eur Urol 2024; 86: 164-82. doi: 10.1016\/j.eururo.2024.04.010","DOI":"10.1016\/j.eururo.2024.04.010"},{"key":"2026071215564884353_j_raon-2025-0061_ref_007","doi-asserted-by":"crossref","unstructured":"Kov\u00e1cs A, Pinkawa M. Interventional therapy in malignant conditions of the prostate. Radiologe 2019; 59: 28-39. doi: 10.1007\/s00117-019-00632-x","DOI":"10.1007\/s00117-019-00632-x"},{"key":"2026071215564884353_j_raon-2025-0061_ref_008","doi-asserted-by":"crossref","unstructured":"Nahar B, Ajami T, Williams A, Soodana Prakash N, Khandekar A, Freitas PFS, et al. Survival outcomes and recurrence patterns following focal high-intensity focused ultrasound treatment for localized prostate cancer: Insights on patient selection and lessons learned. Eur Urol Focus 2025; 11: 235-41. doi: 10.1016\/j.euf.2024.11.005","DOI":"10.1016\/j.euf.2024.11.005"},{"key":"2026071215564884353_j_raon-2025-0061_ref_009","doi-asserted-by":"crossref","unstructured":"Guenther E, Klein N, Zapf S, Weil S, Schlosser C, Rubinsky B, et al. Prostate cancer treatment with irreversible electroporation (IRE): safety, efficacy and clinical experience in 471 treatments. PLoS One 2019; 14: e0215093. doi: 10.1371\/journal.pone.0215093","DOI":"10.1371\/journal.pone.0215093"},{"key":"2026071215564884353_j_raon-2025-0061_ref_010","doi-asserted-by":"crossref","unstructured":"Sersa G, Cemazar M, Snoj M. Electrochemotherapy of tumours. Curr Oncol 2009; 16: 34-5. doi: 10.3747\/co.v16i2.368","DOI":"10.3747\/co.v16i2.368"},{"key":"2026071215564884353_j_raon-2025-0061_ref_011","doi-asserted-by":"crossref","unstructured":"Clover AJP, de Terlizzi F, Bertino G, Curatolo P, Odili J, Campana LG, et al. Electrochemotherapy in the treatment of cutaneous malignancy: Outcomes and subgroup analysis from the cumulative results from the pan-European International Network for Sharing Practice in Electrochemotherapy database for 2482 lesions in 987 patients (2008\u20132019). Eur J Cancer 2020; 138: 30-40. doi: 10.1016\/j.ejca.2020.06.020","DOI":"10.1016\/j.ejca.2020.06.020"},{"key":"2026071215564884353_j_raon-2025-0061_ref_012","doi-asserted-by":"crossref","unstructured":"Iezzi R, Posa A, Caputo CT, De Leoni D, Sbaraglia F, Rossi M, et al. Safety and feasibility of analgosedation for electrochemotherapy of liver lesions. Life 2023; 13: 631. doi: 10.3390\/life13030631","DOI":"10.3390\/life13030631"},{"key":"2026071215564884353_j_raon-2025-0061_ref_013","doi-asserted-by":"crossref","unstructured":"Djokic M, Cemazar M, Bosnjak M, Dezman R, Badovinac D, Miklavcic D, et al. A prospective Phase II study evaluating intraoperative electrochemotherapy of hepatocellular carcinoma. Cancers 2020; 12: 3778. doi: 10.3390\/cancers12123778","DOI":"10.3390\/cancers12123778"},{"key":"2026071215564884353_j_raon-2025-0061_ref_014","doi-asserted-by":"crossref","unstructured":"Granata V, Fusco R, D\u2019Alessio V, Simonetti I, Grassi F, Silvestro L, et al. Percutanous electrochemotherapy (ECT) in primary and secondary liver malignancies: a systematic review. Diagnostics 2023; 13: 209. doi: 10.3390\/diagnostics13020209","DOI":"10.3390\/diagnostics13020209"},{"key":"2026071215564884353_j_raon-2025-0061_ref_015","doi-asserted-by":"crossref","unstructured":"Deschamps F, Tselikas L, Yevich S, Bonnet B, Roux C, Kobe A, et al. Electrochemotherapy in radiotherapy-resistant epidural spinal cord compression in metastatic cancer patients Eur J Cancer 2023; 186: 62-8. doi: 10.1016\/j.ejca.2023.03.012","DOI":"10.1016\/j.ejca.2023.03.012"},{"key":"2026071215564884353_j_raon-2025-0061_ref_016","doi-asserted-by":"crossref","unstructured":"Spallek H, Bischoff P, Zhou W, de Terlizzi F, Jakob F, Kov\u00e0cs A. Percutaneous electrochemotherapy in primary and secondary liver malignancies \u2013 local tumor control and impact on overall survival. Radiol Oncol 2022; 56: 102-10. doi: 10.2478\/raon-2022-0003","DOI":"10.2478\/raon-2022-0003"},{"key":"2026071215564884353_j_raon-2025-0061_ref_017","doi-asserted-by":"crossref","unstructured":"Trotovsek B, Hadzialjevic B, Cemazar M, Sersa G, Djokic M. Laparoscopic electrochemotherapy for the treatment of hepatocellular carcinoma: technological advancement. Front Oncol 2022; 12: 996269. doi: 10.3389\/fonc.2022.996269","DOI":"10.3389\/fonc.2022.996269"},{"key":"2026071215564884353_j_raon-2025-0061_ref_018","doi-asserted-by":"crossref","unstructured":"Mir LM. Bases and rationale of the electrochemotherapy. Eur J Cancer Suppl 2006; 4: 38-44. doi: 10.1016\/j.ejcsup.2006.08.005","DOI":"10.1016\/j.ejcsup.2006.08.005"},{"key":"2026071215564884353_j_raon-2025-0061_ref_019","doi-asserted-by":"crossref","unstructured":"Klein N, Gunther E, Zapf S, El-Idrissi R, Atta J, Stehling M, et al. Prostate cancer infiltrating the bladder sphincter successfully treated with Electrochemotherapy: a case report. Clin Case Rep 2017; 5: 2127-32. doi: 10.1002\/ccr3.1270","DOI":"10.1002\/ccr3.1270"},{"key":"2026071215564884353_j_raon-2025-0061_ref_020","doi-asserted-by":"crossref","unstructured":"Thomas C, Schrader AJ. [New S3 guideline prostate cancer 2021 (Version 6.2) \u2013 What has changed in advanced prostate cancer?] [German]. Urologie 2023; 62: 171-5. doi: 10.1007\/s00120-022-01927-z","DOI":"10.1007\/s00120-022-01927-z"},{"key":"2026071215564884353_j_raon-2025-0061_ref_021","doi-asserted-by":"crossref","unstructured":"Scheltema MJ, Chang JI, van den Bos W, B\u00f6hm M, Delprado W, Gielchinsky I, et al. Preliminary diagnostic accuracy of multiparametric magnetic resonance imaging to detect residual prostate cancer following focal therapy with irreversible electroporation. Eur Urol Focus 2019; 5: 585-91. doi: 10.1016\/j.euf.2017.10.007","DOI":"10.1016\/j.euf.2017.10.007"},{"key":"2026071215564884353_j_raon-2025-0061_ref_022","doi-asserted-by":"crossref","unstructured":"American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: Guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37: 1035-41. doi: 10.1016\/S0360-3016(97)00002-3","DOI":"10.1016\/S0360-3016(97)00002-3"},{"key":"2026071215564884353_j_raon-2025-0061_ref_023","doi-asserted-by":"crossref","unstructured":"Barentsz JO, Weinreb JC, Verma S, Thoeny HC, Tempany CM, Shtern F, et al. Synopsis of the PI-RADS v2 guidelines for multiparametric prostate magnetic resonance imaging and recommendations for use. Eur Urol 2016; 69: 41-9. doi: 10.1016\/j.eururo.2015.08.038","DOI":"10.1016\/j.eururo.2015.08.038"},{"key":"2026071215564884353_j_raon-2025-0061_ref_024","doi-asserted-by":"crossref","unstructured":"Ghoreifi A, Gomella L, Hu JC, Konety B, Lunelli L, Rastinehad AR, et al. Identifying the best candidate for focal therapy: a comprehen-sive review. Prostate Cancer Prostatic Dis 2025; 28: 684-92. doi: 10.1038\/s41391-024-00907-y","DOI":"10.1038\/s41391-024-00907-y"},{"key":"2026071215564884353_j_raon-2025-0061_ref_025","doi-asserted-by":"crossref","unstructured":"Guillaumier S, Peters M, Arya M, Afzal N, Charman S, Dudderidge T, et al. A multicentre study of 5-year outcomes following focal therapy in treating clinically significant nonmetastatic prostate cancer. Eur Urol 2018; 74: 422-9. doi: 10.1016\/j.eururo.2018.06.006","DOI":"10.1016\/j.eururo.2018.06.006"},{"key":"2026071215564884353_j_raon-2025-0061_ref_026","doi-asserted-by":"crossref","unstructured":"Richardson S, Gonzalez S, Mahajan A, Kwan L, Delfin M, Brisbane W, et al. MP04-16 focal therapy in high-risk prostate cancer: can we expand eligibility criteria? J Urol 2025; 213: e125. doi: 10.1097\/01. ju.0001109744.01835.94.16.","DOI":"10.1097\/01.JU.0001109744.01835.94.16"},{"key":"2026071215564884353_j_raon-2025-0061_ref_027","doi-asserted-by":"crossref","unstructured":"Gehl J, Skovsgaard T, Mir LM. Enhancement of cytotoxicity by electropermeabilization: an improved method for screening drugs. Anti-Cancer Drugs 1998; 9: 319-26. doi: 10.1097\/00001813-199804000-00005","DOI":"10.1097\/00001813-199804000-00005"},{"key":"2026071215564884353_j_raon-2025-0061_ref_028","doi-asserted-by":"crossref","unstructured":"Ueki T, Uemura H, Nagashima Y, Ohta S, Ishiguro H, Kubota Y Antitumour effect of electrochemotherapy with bleomycin on human prostate cancer xenograft. BJU Int 2008; 102: 1467-71. doi: 10.1111\/j.1464-410x.2008.07793.x","DOI":"10.1111\/j.1464-410X.2008.07793.x"},{"key":"2026071215564884353_j_raon-2025-0061_ref_029","doi-asserted-by":"crossref","unstructured":"Parker C, Castro E, Fizazi K, Heidenreich A, Ost P, Procopio G, et al. Prostate cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol 2020; 31: 1119-34. doi: 10.1016\/j.annonc.2020.06.011","DOI":"10.1016\/j.annonc.2020.06.011"},{"key":"2026071215564884353_j_raon-2025-0061_ref_030","doi-asserted-by":"crossref","unstructured":"Lane JA, Donovan JL, Young GJ, Davis M, Walsh EI, Avery KNL, et al. Functional and quality of life outcomes of localised prostate cancer treatments (Prostate Testing for Cancer and Treatment [PROTECT] study). BJU Int 2022; 130: 370-80. doi: 10.1111\/bju.15739","DOI":"10.1111\/bju.15739"},{"key":"2026071215564884353_j_raon-2025-0061_ref_031","doi-asserted-by":"crossref","unstructured":"Seymour ZA, Daignault-Newton S, McLaughlin PW, Sandler H, Jackson W, Johnson SB, et al. Patient reported outcomes for quality of life (QOL) by Expanded Prostate Cancer Index (EPIC) on average 15 years post treatment. Clin Transl Radiat Oncol 2022; 36: 56-62. doi: 10.1016\/j.ctro.2022.05.007","DOI":"10.1016\/j.ctro.2022.05.007"},{"key":"2026071215564884353_j_raon-2025-0061_ref_032","doi-asserted-by":"crossref","unstructured":"Shoji S, Kuroda S, Uemura K, Oda K, Kano T, Ogawa T, et al. Risk factors for severe erectile dysfunction after focal therapy with high-intensity focused ultrasound for prostate cancer. Biomedicines 2022; 10: 2876. doi: 10.3390\/biomedicines10112876","DOI":"10.3390\/biomedicines10112876"},{"key":"2026071215564884353_j_raon-2025-0061_ref_033","doi-asserted-by":"crossref","unstructured":"Zhou JT, Fang DM, Xia S, Li T, Liu RL. The incidence proportion of erectile dysfunction in patients treated with cryotherapy for prostate cancer: a meta-analysis. Clin Transl Oncol 2019; 21: 1152-8. doi: 10.1007\/s12094-019-02036-8","DOI":"10.1007\/s12094-019-02036-8"},{"key":"2026071215564884353_j_raon-2025-0061_ref_034","doi-asserted-by":"crossref","unstructured":"Tucker RD, Huidobro C, Larson T. Ablation of stage T1\/T2 prostate cancer with permanent interstitial temperature self-regulating rods. J Endourol 2005; 19: 865-7. doi: 10.1089\/end.2005.19.865","DOI":"10.1089\/end.2005.19.865"}],"container-title":["Radiology and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/raon-2025-0061","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T23:37:08Z","timestamp":1783899428000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/raon-2025-0061"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,1]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,16]]},"published-print":{"date-parts":[[2025,12,1]]}},"alternative-id":["10.2478\/raon-2025-0061"],"URL":"https:\/\/doi.org\/10.2478\/raon-2025-0061","relation":{},"ISSN":["1581-3207"],"issn-type":[{"value":"1581-3207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,1]]}}}