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available at http://www.ncbi.nlm.nih.gov/pubmed/31103721 Editorial Comment: There is increasing interest in focal ablative therapy as a means of treating unifocal or limited focality early stage prostate cancer. Improved imaging and biopsy techniques have allowed intraprostatic localization of prostate tumors and attempts at partial gland destruction. In this report the authors present a well standardized cohort of men treated for intermediate risk localized prostate cancer with magnetic resonance imaging guided focal ablation using irreversible electroporation. Electroporation works through destruction of the cell membrane by electrical current, resulting in cell death without a great deal of thermal energy dispersion. Men were treated between 2014 and 2017 and the data were entered into a prospective registry. Only men achieving 1-year followup (123 patients) and posttreatment biopsy (101) are included in the study. The authors report that in-field recurrence was noted in 9.7% of all men treated, while out-offield recurrence was seen in 12.7%. On changing technique to include a 10 mm margin of ablation around the magnetic resonance imaging demonstrable tumor the in-field recurrence dropped to 2.7% and out-of-field recurrence remained at 12.1%, indicating that improved tumor control can be achieved through improved margin control. Overall, complication rates were low, although just over 20% of men complained of short-term side effects, predominantly urinary, and approximately 25% of men reported significant reduction in potency, with mean EPIC (Expanded Prostate Cancer Index Composite) sexual function score declining from 65 to 50 points during the first year of followup. Strengths of the study appear to be standardized rigorous selection criteria, uniform followup and recording, and use of targeted and transperineal template mapping biopsies at 1 year to determine efficacy. The latter point is critical as the true efficacy of ablative therapy can likely be determined only if patients are adequately sampled after treatment. Samir S. Taneja, MD Suggested Reading Valerio M, Dickinson L, Ali A et al: Nanoknife electroporation ablation trial: a prospective development study investigating focal irreversible electroporation for localized prostate cancer. J Urol 2017; 197: 647. Murray KS, Ehdaie B, Musser J et al: Pilot study to assess safety and clinical outcomes of irreversible electroporation for partial gland ablation in men with prostate cancer. J Urol 2016; 196: 883. van den Bos W, Jurhill RR, de Bruin DM et al: Histopathological outcomes after irreversible electroporation for prostate cancer: results of an ablate and resect study. J Urol 2016; 196: 552. 254 PROSTATE CANCER Copyright © 20 American Urological Association Education and Research Inc Unauthorized reproduction of this article is prohibite 20