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Open Access 01-10-2019 | Prostate Cancer | Original Article

Focal laser ablation as clinical treatment of prostate cancer: report from a Delphi consensus project

Authors: A. van Luijtelaar, B. M. Greenwood, H. U. Ahmed, A. B. Barqawi, E. Barret, J. G. R. Bomers, M. A. Brausi, P. L. Choyke, M. R. Cooperberg, S. Eggener, J. F. Feller, F. Frauscher, A. K. George, R. G. Hindley, S. F. M. Jenniskens, L. Klotz, G. Kovacs, U. Lindner, S. Loeb, D. J. Margolis, L. S. Marks, S. May, T. D. Mcclure, R. Montironi, S. G. Nour, A. Oto, T. J. Polascik, A. R. Rastinehad, T. M. De Reyke, J. S. Reijnen, J. J. M. C. H. de la Rosette, J. P. M. Sedelaar, D. S. Sperling, E. M. Walser, J. F. Ward, A. Villers, S. Ghai, J. J. Fütterer

Published in: World Journal of Urology | Issue 10/2019

Abstract

Purpose

To define the role of focal laser ablation (FLA) as clinical treatment of prostate cancer (PCa) using the Delphi consensus method.

Methods

A panel of international experts in the field of focal therapy (FT) in PCa conducted a collaborative consensus project using the Delphi method. Experts were invited to online questionnaires focusing on patient selection and treatment of PCa with FLA during four subsequent rounds. After each round, outcomes were displayed, and questionnaires were modified based on the comments provided by panelists. Results were finalized and discussed during face-to-face meetings.

Results

Thirty-seven experts agreed to participate, and consensus was achieved on 39/43 topics. Clinically significant PCa (csPCa) was defined as any volume Grade Group 2 [Gleason score (GS) 3+4]. Focal therapy was specified as treatment of all csPCa and can be considered primary treatment as an alternative to radical treatment in carefully selected patients. In patients with intermediate-risk PCa (GS 3+4) as well as patients with MRI-visible and biopsy-confirmed local recurrence, FLA is optimal for targeted ablation of a specific magnetic resonance imaging (MRI)-visible focus. However, FLA should not be applied to candidates for active surveillance and close follow-up is required. Suitability for FLA is based on tumor volume, location to vital structures, GS, MRI-visibility, and biopsy confirmation.

Conclusion

Focal laser ablation is a promising technique for treatment of clinically localized PCa and should ideally be performed within approved clinical trials. So far, only few studies have reported on FLA and further validation with longer follow-up is mandatory before widespread clinical implementation is justified.

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Title: Focal laser ablation as clinical treatment of prostate cancer: report from a Delphi consensus project
Authors: A. van Luijtelaar
B. M. Greenwood
H. U. Ahmed
A. B. Barqawi
E. Barret
J. G. R. Bomers
M. A. Brausi
P. L. Choyke
M. R. Cooperberg
S. Eggener
J. F. Feller
F. Frauscher
A. K. George
R. G. Hindley
S. F. M. Jenniskens
L. Klotz
G. Kovacs
U. Lindner
S. Loeb
D. J. Margolis
L. S. Marks
S. May
T. D. Mcclure
R. Montironi
S. G. Nour
A. Oto
T. J. Polascik
A. R. Rastinehad
T. M. De Reyke
J. S. Reijnen
J. J. M. C. H. de la Rosette
J. P. M. Sedelaar
D. S. Sperling
E. M. Walser
J. F. Ward
A. Villers
S. Ghai
J. J. Fütterer
Publication date: 01-10-2019
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Laser
Published in: World Journal of Urology / Issue 10/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02636-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Focal laser ablation as clinical treatment of prostate cancer: report from a Delphi consensus project

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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