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Brief Correspondence

Complications, Recovery, and Early Functional Outcomes and Oncologic Control Following In-bore Focal Laser Ablation of Prostate Cancer

By: Herbert Lepor a , Elton Llukani a , Daniel Sperling b and Jurgen J. Fütterer c

European Urology, Volume 68 Issue 6, December 2015, Pages 924-926

Published online: 01 December 2015

Keywords: Focal laser ablation, Focal therapy, Prostate cancer, Prostate cancer treatment outcomes

Abstract Full Text Full Text PDF (215 KB) Patient Summary

Abstract

From April 2013 to July 2014, 25 consecutive men participated in a longitudinal outcomes study following in-bore magnetic resonance imaging (MRI)-guided focal laser ablation (FLA) of prostate cancer (PCa). Eligibility criteria were clinical stage T1c and T2a disease; prostate-specific antigen (PSA) <10 ng/ml; Gleason score <8; and cancer-suspicious regions (CSRs) on multiparametric MRI harboring PCa. CSRs harboring PCa were ablated using a Visualase cooled laser applicator system. Tissue temperature was monitored throughout the ablation cycle by proton resonance frequency shift magnetic resonance thermometry from phase-sensitive images. There were no significant differences between baseline and 3-mo mean American Urological Association Symptom Score or Sexual Health Inventory in Men scores. No man required pads at any time. Overall, the mean PSA decrease between baseline and 3 mo was 2.3 ng/ml (44.2%). Of 28 sites subjected to target biopsy after FLA, 26 (96%) showed no evidence of PCa. Our study provides encouraging evidence that excellent early oncologic control of significant PCa can be achieved following FLA, with virtually no complications or adverse impact on quality of life. Longer follow-up is required to show that oncologic control is durable.

Patient summary

Early results for focal laser ablation of prostate cancer are very encouraging. Until long-term oncologic control is demonstrated, focal laser ablation must be considered an investigational treatment option.

Take Home Message

Focal laser ablation reliably ablates biopsy-proven prostate cancer–suspicious regions detected on multiparametric magnetic resonance imaging. Oncologic control based on post-procedure targeted biopsy is achieved with expedited recovery, no post-procedure incontinence episodes, improvement in lower urinary tract symptoms, and no adverse impact on sexual function.

Keywords: Focal laser ablation, Focal therapy, Prostate cancer, Prostate cancer treatment outcomes.

Footnotes

a Department of Urology, Smilow Comprehensive Prostate Cancer Center, New York University School of Medicine, New York, NY, USA

b Sperling Prostate Cancer Center, New York, NY, USA

c Department of Radiology, Radboudumc, Nijmegen, The Netherlands

Corresponding author. Department of Urology, NYU School of Medicine, 150 East 32nd Street, New York, NY 10016, USA. Tel. +1 646 8256380; Fax: +1 646 8256399.

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