Background: Focal therapy has emerged as a viable alternative to radical prostate cancer treatment, offering oncologic control while minimizing morbidity. EchoLaser focal laser ablation (FLA) is a minimally invasive technique that utilizes high-precision laser energy for tumor destruction. This study evaluated the oncologic outcomes, procedural efficiency, and safety of EchoLaser focal therapy, comparing fiducial-assisted (FM+) and non-fiducial (FM−) approaches.Methods: A retrospective cohort study was conducted at Athens Medical Center, Greece, including 50 patients with localized prostate cancer treated with EchoLaser therapy. Patients were categorized into FM+ (n = 31) and FM− (n = 19) groups. Oncologic control (MRI and PSA levels at six months), procedural efficiency (operative time), and safety (adverse events) were assessed.Results: At six months, 80% of patients (n = 40) had no residual disease on MRI, while 20% (n = 10) showed persistent or recurrent tumor activity. PSA levels declined from 10.26 ± 14.99 ng/mL to 2.70 ± 2.67 ng/mL, reflecting a 74% median reduction. Procedure time was shorter in FM+ patients (33.48 ± 2.41 min vs. 45.79 ± 2.92 min,p< 0.01). Adverse events occurred only in the FM− group, including one case of urinary retention.Conclusions: FLA with EchoLaser using fiducial marker enhances procedural efficiency and could have a positive impact on oncologic control. These findings suggest that fiducial markers should be integrated into focal therapy protocols. Longer follow-up studies are needed to confirm the long-term outcomes.
背景：局部治疗已成为根治性前列腺癌治疗的有效替代方案，在实现肿瘤控制的同时最大程度降低并发症风险。EchoLaser局部激光消融术是一种微创技术，利用高精度激光能量实现肿瘤灭活。本研究评估了EchoLaser局部治疗的肿瘤学结局、手术效率及安全性，并比较了基准标记辅助（FM+）与非基准标记（FM-）两种术式。 方法：在希腊雅典医疗中心开展回顾性队列研究，纳入50例接受EchoLaser治疗的局限性前列腺癌患者。患者分为FM+组（31例）和FM-组（19例）。评估指标包括肿瘤控制情况（6个月时MRI及PSA水平）、手术效率（操作时间）及安全性（不良事件）。 结果：6个月随访时，80%患者（40例）MRI显示无残留病灶，20%患者（10例）存在持续或复发性肿瘤活性。PSA水平从10.26±14.99 ng/mL降至2.70±2.67 ng/mL，中位降幅达74%。FM+组手术时间显著缩短（33.48±2.41分钟 vs 45.79±2.92分钟，p<0.01）。不良事件仅发生于FM-组，包括1例尿潴留。 结论：采用基准标记的EchoLaser激光消融术可提升手术效率，并可能对肿瘤控制产生积极影响。研究结果表明基准标记应纳入局部治疗规范。需开展长期随访研究以确认远期疗效。
Echolaser Focal Treatment for Prostate Cancer Guided by Fiducial Marker Placement
肿瘤(癌症)患者之家