Guidance

1 Recommendations

1 Recommendations

1.1 Irreversible electroporation for treating prostate cancer should only be used with special arrangements for clinical governance, consent, and audit or research. Find out what special arrangements mean on the NICE interventional procedures guidance page.

1.2 Clinicians wanting to do irreversible electroporation for treating prostate cancer should:

  • Inform the clinical governance leads in their healthcare organisation.

  • Ensure that people (and their families and carers as appropriate) understand the procedure's safety and efficacy, and any uncertainties about these.

  • Take account of NICE's advice on shared decision making, including NICE's information for the public.

  • Audit and review clinical outcomes of everyone having the procedure. The main efficacy and safety outcomes identified in this guidance can be entered into NICE's interventional procedure outcomes audit tool (for use at local discretion).

  • Discuss the outcomes of the procedure during their annual appraisal to reflect, learn and improve.

1.3 Healthcare organisations should:

  • Ensure systems are in place that support clinicians to collect and report data on outcomes and safety for everyone having this procedure.

  • Regularly review data on outcomes and safety for this procedure.

1.4 Further research should ideally be randomised controlled trials with an appropriate comparator. Further research could also include analysis of registry data or research databases. It should include details of patient selection, details of the procedure (including imaging) and short- and long-term outcomes.

Why the committee made these recommendations

There is enough evidence to suggest that the procedure works and does not raise any major safety concerns in the short- and medium term. The procedure can have complications and it is uncertain how well it works in the long term. It is also uncertain who would benefit most from the procedure and at what stage of their prostate cancer treatment it would be most effective. So, it can be used with special arrangements, and further data collection is needed.