75 - Safety and Efficacy of Prostate Artery Embolization with N-BCA to Treat Lower Urinary Tract Symptoms in Patients with Gleason 6 Prostate Cancer

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Ramita N. Gowda, MPH

Medical Student
St. George's University School of Medicine, United States

Author/Co-author(s)

Jade Lerner, MD (she/her/hers)

Resident
Icahn School of Medicine at Mount Sinai, United States
David Bamshad, MD

Fellow PGY6
The Mount Sinai Hospital, United States
JV

Jenanan Vairavamurthy, MD

Assistant Professor of Radiology
Mount Sinai, United States
Vivian Bishay, MD

Associate Professor
Icahn School of Medicine at Mount Sinai Hospital, United States
Dan Shilo, MD

Assistant Professor
Mount Sinai, United States
KG

Kirema Garcia-Reyes, MD

Assistant Professor
Mount Sinai, United States
RP

Rajesh I. Patel, MD

Assistant Professor of Radiology and Surgery
Icahn School of Medicine at Mount Sinai, United States
Robert A. Lookstein, MD

Professor of Radiology and Surgery
Icahn School of Medicine at Mount Sinai, United States
AF

Aaron M. Fischman, MD

Professor of Radiology and Surgery
Mount Sinai Health System, United States

Purpose:

Prostate artery embolization (PAE) is increasingly recognized as an effective treatment for lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH). However, there is limited data on its safety and efficacy in patients with concomitant Gleason 6/7 prostate cancer. This study evaluates the safety and efficacy of PAE with N-butyl cyanoacrylate (N-BCA) in treating LUTS in patients under active surveillance for Gleason 6 prostate cancer.

Materials and Methods:

We conducted a retrospective analysis of 198 patients who underwent PAE with n-BCA for BPH LUTS between June 2022 and September 2024, of which 10 patients had concurrent Gleason 6 prostate cancer. The patients had been diagnosed with Gleason 6 and were under active surveillance for prostate cancer. 2 patients required catheterization pre-procedure. Each underwent PAE with N-BCA, using less than 1 cc of glue per procedure. Pre- and post-procedure International Prostate Symptom Scores (IPSS) were collected, along with PSA levels and imaging to monitor prostate cancer. The primary outcomes were clinical success in LUTS improvement and oncologic safety.

Results:

The mean pre-procedure IPSS was 17.5. A mean improvement of 20% in IPSS scores was observed at 6 weeks (p=0.18). There were no major adverse events related to the procedure, and no patients showed evidence of oncologic progression on follow-up imaging or significant PSA increases. Technical success of bilateral embolization was achieved in 100% patients.

Conclusion:

PAE with N-BCA demonstrated safety and efficacy in patients with Gleason 6 prostate cancer and LUTS, with all patients achieving LUTS relief. There was no adverse impact on PSA levels or prostate cancer status. These findings suggest PAE with N-BCA is a viable option for managing LUTS in this patient population. Further study and long-term follow-up of the cohort are planned.