Safety and Feasibility of Soractelite Transperineal Focal Laser Ablation for Prostate Cancer and Short-term Quality of Life Analysis from a Multicenter Pilot Study

Luigi A M J G van Riel, Rob A A van Kollenburg, André N Vis, Pim J van Leeuwen, Theo M de Reijke, Daniel M de Bruin, Jorg R Oddens, Luigi A M J G van Riel, Rob A A van Kollenburg, André N Vis, Pim J van Leeuwen, Theo M de Reijke, Daniel M de Bruin, Jorg R Oddens

Abstract

Background: Soractelite™ transperineal focal laser ablation (TPLA) for the treatment of localized prostate cancer (PCa) using the Echolaser® system is a novel minimally invasive technique that has the potential to induce tissue ablation, while reducing treatment-related morbidity, when compared with robot-assisted radical prostatectomy (RARP) and radiotherapy.

Objective: To determine the short-term safety and feasibility of single or multifiber TPLA, its functional outcomes, and quality of life (QoL).

Design setting and participants: TPLA was performed in 12 patients, consecutively assigned to four treatment regimens, with localized PCa who were scheduled for RARP ("ablate and resect design"). The treatment regimens were as follows: (1) a single fiber at 3 W, (2) two fibers at 5 mm distance at 3 W, (3) two fibers at 10 mm distance at 3 W, and (4) a single fiber at 5 W. TPLA was scheduled 4 wk prior to RARP.

Intervention: TPLA using the Echolaser® system under local anesthesia at the outpatient clinic.

Outcome measurements and statistical analysis: Safety and feasibility were determined by the assessment of device-related peri- and postoperative adverse events (AEs), and length of hospital stay. Functional outcomes and QoL were measured using validated questionnaires. Feasibility of RARP was assessed by a questionnaire for the urologist.

Results and limitations: Patients were dismissed after a median (interquartile range) hospital admission of 3.25 (1.25) h. No device-related AEs occurred. AEs that occurred were mostly related to lower urinary tract symptoms and were mild (grade 1-2). Most AEs resolved within 1 wk. A QoL analysis showed no significant differences for all treatment regimens. Functional outcomes remained unchanged, except for erectile function after 1 wk, which returned to baseline after 4 wk. TPLA treatment did not compromise RARP, based on the questionnaires.

Conclusions: TPLA for the treatment of PCa at the outpatient clinic appears to be safe and feasible with good short-term QoL and functional outcomes; oncological results are awaited.

Patient summary: Focal treatment of localized prostate cancer can safely be performed in a daycare setting using a new technique, based on laser ablation, without compromising quality of life.

Keywords: Focal therapy; Laser ablation; Minimally invasive therapy; Prostatic neoplasm.

© 2022 The Author(s).

Figures

Fig. 1
Fig. 1
Overview of quality of life (VAS, IPSS QoL, and EPIC quality of life domain scores) and functional outcomes (IIEF-15, IPSS scores, Qmax [ml/s], and residual urine [ml]) at baseline, and 1 and 4 wk following treatment. Circle symbols represent outliers and the asterisk symbol represents a significant change (p < 0.05). EPIC = Expanded Prostate Cancer Index Composite; IIEF-15 = International Index of Erectile Function; IPSS = International Prostate Symptom Score; QoL = quality of life; VAS = visual analog scale.

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