Focal Laser Ablation Offers Oncological and Functional Control Compared to Other Focal Therapies: Study
Australia: Researchers have found in a systematic review and meta-analysis that focal laser ablation offers oncological control comparable to other focal therapies while preserving functional outcomes. However, the lack of high-quality comparative studies emphasizes the need for further robust research to confirm these results.
The study, published in BJU International, was led by Ymer Bushati from the Nepean Urology Research Group, Kingswood, New South Wales, Australia, along with colleagues. The investigators aimed to assess both cancer control and functional outcomes associated with focal laser ablation (FLA) in men with localised prostate cancer, an area of growing interest as clinicians seek treatment strategies that balance disease eradication with quality-of-life preservation.
The researchers conducted a systematic review and meta-analysis in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic database searches identified studies reporting clinical outcomes following FLA in patients with localised prostate cancer. The primary endpoint was oncological control, measured by recurrence of clinically significant cancer on follow-up biopsy and changes in prostate-specific antigen (PSA) levels. Secondary outcomes included treatment-related adverse events and post-procedure sexual and urinary function.
Key Findings:
- Twelve studies involving 421 patients who underwent focal laser ablation (FLA) were included in the analysis.
- Recurrence of clinically significant prostate cancer on follow-up biopsy occurred in 15% of patients.
- Mean PSA levels decreased by 2.3 ng/mL at 12 months after FLA.
- A statistically significant decline in sexual function was observed following FLA, but the effect size was small and not clinically meaningful (Cohen’s d = 0.29).
- Urinary function showed no statistically significant deterioration after treatment.
These results indicate that FLA may help preserve urinary continence and minimize sexual side effects compared to more radical interventions.
The authors noted considerable variability across the included studies, particularly in patient selection criteria, follow-up strategies, and definitions of cancer recurrence. This heterogeneity limits direct comparison between studies and affects the broader applicability of the findings.
Overall, the analysis suggests that focal laser ablation represents a promising minimally invasive option for selected patients with localised prostate cancer, offering reasonable cancer control while maintaining functional outcomes. Nevertheless, the researchers emphasized the need for well-designed comparative trials with standardized outcome measures to more definitively establish the role of FLA in contemporary prostate cancer management.
Reference:
Bushati Y, Guo AA, Muston BT, Bushati A, Sathianathen N, Kam J, Teoh J, Khadra M, Thangasamy I. Focal laser ablation in prostate cancer: a systematic review and meta-analysis. BJU Int. 2026 Feb;137(2):251-259. doi: 10.1111/bju.70064. Epub 2025 Nov 4. PMID: 41188055.
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