Objectives: The aim of this work was to review the available evidence on transperineal focal laser ablation (FLA) for patients with localized PCa, focusing on both functional and oncological outcomes.Methods: A comprehensive review of the English-language literature was performed using the MEDLINE (via PubMed) and Web of Science (WOS) databases until 30 December 2024, using a combination of free text and MeSH subject headings. The review process was carried out according to the PRISMA guidelines.Results: The literature search found 156 papers, and among these, 10 papers were finally accepted and included. A risk of bias assessment was conducted, revealing low-quality evidence and high heterogeneity among the available data. Low- to high-risk cancers were treated across the studies. A drop in PSA values was observed in all studies after FLA, but no definition of biochemical disease-free survival was established. The postfocal presence of cancer rate ranged from 4% to 57%, while clinically significant cancer was detected in 0 up to 31% of cases. Secondary treatments were necessary for 7 to 30%. The overall complication rate ranged from 0% to 66%, most being mild and transient. Functional outcomes appeared to be preserved both in the short- and long-term follow-ups. Quantitative analyses were not performed due to the low number and heterogeneity of the studies included.Conclusions: Transperineal FLA for the treatment of clinically localized prostate cancer appears to be a feasible, safe technique with an efficacy comparable to other focal therapy modalities. However, the low quality of the evidence available highlights the need for comparative, randomized long-term follow-up studies versus standard of care and other focal therapy options in order to standardize patient selection, treatment protocols, and follow-up strategies.
目的：本研究旨在系统回顾经会阴局灶性激光消融术治疗局限性前列腺癌的现有证据，重点关注其功能性与肿瘤学结局。 方法：通过MEDLINE（经由PubMed）和Web of Science数据库，综合运用自由词与医学主题词对截至2024年12月30日的英文文献进行全面检索。文献筛选过程严格遵循PRISMA指南进行。 结果：初检获得156篇文献，经筛选最终纳入10篇研究。偏倚风险评估显示现有证据质量较低且存在高度异质性。纳入研究涵盖低危至高危前列腺癌患者。所有研究均观察到FLA术后PSA值下降，但均未明确生化无病生存的定义。术后残留癌检出率为4%至57%，其中临床显著性癌检出率为0%至31%。7%至30%的患者需接受二次治疗。总体并发症发生率为0%至66%，多数为轻微且可逆性并发症。短期与长期随访均显示患者功能结局保持良好。由于纳入研究数量有限且异质性较高，未进行定量分析。 结论：经会阴局灶性激光消融术治疗临床局限性前列腺癌具有可行性及安全性，其疗效与其他局灶治疗方式相当。然而现有证据质量较低，亟需开展与标准治疗方案及其他局灶治疗方式的随机对照长期随访研究，以规范患者选择标准、治疗方案及随访策略。
肿瘤(癌症)患者之家