Focal Laser Ablation of Prostate Cancer: Results in 120 Patients with Low- to Intermediate-Risk Disease

Eric Walser, Anne Nance, Leslie Ynalvez, Shan Yong, Jacqueline Aoughsten, Eduardo Eyzaguirre, Stephen Williams

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Abstract

Purpose: Can focal laser ablation (FLA) of low to intermediate risk prostate cancer preserve sexual and urinary function with low morbidity while providing adequate oncologic outcomes. Materials and Methods: Transrectal FLA was done in 120 patients with low- to intermediate-risk prostate cancer. MR imaging thermometry controlled ablation. At 6 and 12 months, patients had clinical and MR imaging follow-up with biopsy of suspicious areas. Patients submitted surveys of sexual and urinary function. Multivariate logistic regression identified determinants of positive imaging and biopsies. Two-sided Wilcoxon signed rank test evaluated scores and laboratory values. Results: Median patient age was 64 years, and median prostate-specific antigen (PSA) was 6.05 ng/mL. Median follow-up period was 34 months (range, 17–55 months). Gleason score was 3+3=6 in 37 (30.8%), 3+4=7 in 56 (46.7%), and 4+3=7 in 27 (22.5%) patients. Tumor stage was T1c in 89 (74.2%), T2a in 26 (21.7%), and T2b in 5 (4.2%) patients. Twenty (17%) patients had additional oncologic therapy 1 year after FLA when biopsy confirmed cancer following abnormal MR imaging. There was no difference between functional scores before and after ablation. Median PSA decreased to 3.25 at 12 months (P <.001). Tumor diameter above the median (odds ratio = 3.36; 95% confidence interval, 1.41–7.97) was the only significant predictor for positive MR imaging after treatment. Conclusions: One year after FLA, selected patients had low morbidity, no significant changes in quality of life, and 83% freedom of retreatment rate. Sexual and urinary function did not significantly change after FLA.

Original languageEnglish (US)
Pages (from-to)401-409.e2
JournalJournal of Vascular and Interventional Radiology
Volume30
Issue number3
DOIs
StatePublished - Mar 1 2019

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Laser Therapy
Prostatic Neoplasms
Prostate-Specific Antigen
Biopsy
Thermometry
Morbidity
Neoplasms
Retreatment
Neoplasm Grading
Nonparametric Statistics
Logistic Models
Odds Ratio
Quality of Life
Confidence Intervals
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Focal Laser Ablation of Prostate Cancer: Results in 120 Patients with Low- to Intermediate-Risk Disease",
abstract = "Purpose: Can focal laser ablation (FLA) of low to intermediate risk prostate cancer preserve sexual and urinary function with low morbidity while providing adequate oncologic outcomes. Materials and Methods: Transrectal FLA was done in 120 patients with low- to intermediate-risk prostate cancer. MR imaging thermometry controlled ablation. At 6 and 12 months, patients had clinical and MR imaging follow-up with biopsy of suspicious areas. Patients submitted surveys of sexual and urinary function. Multivariate logistic regression identified determinants of positive imaging and biopsies. Two-sided Wilcoxon signed rank test evaluated scores and laboratory values. Results: Median patient age was 64 years, and median prostate-specific antigen (PSA) was 6.05 ng/mL. Median follow-up period was 34 months (range, 17–55 months). Gleason score was 3+3=6 in 37 (30.8{\%}), 3+4=7 in 56 (46.7{\%}), and 4+3=7 in 27 (22.5{\%}) patients. Tumor stage was T1c in 89 (74.2{\%}), T2a in 26 (21.7{\%}), and T2b in 5 (4.2{\%}) patients. Twenty (17{\%}) patients had additional oncologic therapy 1 year after FLA when biopsy confirmed cancer following abnormal MR imaging. There was no difference between functional scores before and after ablation. Median PSA decreased to 3.25 at 12 months (P <.001). Tumor diameter above the median (odds ratio = 3.36; 95{\%} confidence interval, 1.41–7.97) was the only significant predictor for positive MR imaging after treatment. Conclusions: One year after FLA, selected patients had low morbidity, no significant changes in quality of life, and 83{\%} freedom of retreatment rate. Sexual and urinary function did not significantly change after FLA.",
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T1 - Focal Laser Ablation of Prostate Cancer

T2 - Results in 120 Patients with Low- to Intermediate-Risk Disease

AU - Walser, Eric

AU - Nance, Anne

AU - Ynalvez, Leslie

AU - Yong, Shan

AU - Aoughsten, Jacqueline

AU - Eyzaguirre, Eduardo

AU - Williams, Stephen

PY - 2019/3/1

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N2 - Purpose: Can focal laser ablation (FLA) of low to intermediate risk prostate cancer preserve sexual and urinary function with low morbidity while providing adequate oncologic outcomes. Materials and Methods: Transrectal FLA was done in 120 patients with low- to intermediate-risk prostate cancer. MR imaging thermometry controlled ablation. At 6 and 12 months, patients had clinical and MR imaging follow-up with biopsy of suspicious areas. Patients submitted surveys of sexual and urinary function. Multivariate logistic regression identified determinants of positive imaging and biopsies. Two-sided Wilcoxon signed rank test evaluated scores and laboratory values. Results: Median patient age was 64 years, and median prostate-specific antigen (PSA) was 6.05 ng/mL. Median follow-up period was 34 months (range, 17–55 months). Gleason score was 3+3=6 in 37 (30.8%), 3+4=7 in 56 (46.7%), and 4+3=7 in 27 (22.5%) patients. Tumor stage was T1c in 89 (74.2%), T2a in 26 (21.7%), and T2b in 5 (4.2%) patients. Twenty (17%) patients had additional oncologic therapy 1 year after FLA when biopsy confirmed cancer following abnormal MR imaging. There was no difference between functional scores before and after ablation. Median PSA decreased to 3.25 at 12 months (P <.001). Tumor diameter above the median (odds ratio = 3.36; 95% confidence interval, 1.41–7.97) was the only significant predictor for positive MR imaging after treatment. Conclusions: One year after FLA, selected patients had low morbidity, no significant changes in quality of life, and 83% freedom of retreatment rate. Sexual and urinary function did not significantly change after FLA.

AB - Purpose: Can focal laser ablation (FLA) of low to intermediate risk prostate cancer preserve sexual and urinary function with low morbidity while providing adequate oncologic outcomes. Materials and Methods: Transrectal FLA was done in 120 patients with low- to intermediate-risk prostate cancer. MR imaging thermometry controlled ablation. At 6 and 12 months, patients had clinical and MR imaging follow-up with biopsy of suspicious areas. Patients submitted surveys of sexual and urinary function. Multivariate logistic regression identified determinants of positive imaging and biopsies. Two-sided Wilcoxon signed rank test evaluated scores and laboratory values. Results: Median patient age was 64 years, and median prostate-specific antigen (PSA) was 6.05 ng/mL. Median follow-up period was 34 months (range, 17–55 months). Gleason score was 3+3=6 in 37 (30.8%), 3+4=7 in 56 (46.7%), and 4+3=7 in 27 (22.5%) patients. Tumor stage was T1c in 89 (74.2%), T2a in 26 (21.7%), and T2b in 5 (4.2%) patients. Twenty (17%) patients had additional oncologic therapy 1 year after FLA when biopsy confirmed cancer following abnormal MR imaging. There was no difference between functional scores before and after ablation. Median PSA decreased to 3.25 at 12 months (P <.001). Tumor diameter above the median (odds ratio = 3.36; 95% confidence interval, 1.41–7.97) was the only significant predictor for positive MR imaging after treatment. Conclusions: One year after FLA, selected patients had low morbidity, no significant changes in quality of life, and 83% freedom of retreatment rate. Sexual and urinary function did not significantly change after FLA.

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