# Echolaser Focal Treatment for Prostate Cancer Guided by Fiducial Marker Placement

## TL;DR

This study shows that using fiducial markers with laser ablation improves prostate cancer treatment accuracy and reduces procedure time.

## Contribution

The study demonstrates that fiducial-assisted EchoLaser focal therapy improves procedural efficiency and oncologic outcomes in prostate cancer treatment.

## Key findings

- Patients with fiducial markers had shorter procedure times and better treatment success.
- PSA levels decreased significantly in patients after six months of treatment.
- Adverse events were observed only in the non-fiducial group.

## Abstract

Prostate cancer is one of the most common cancers in men, and treatment options often involve surgery or radiation, which can lead to side effects such as urinary incontinence and erectile dysfunction. Focal therapy is a newer approach that targets only the cancerous part of the prostate, preserving healthy tissue and reducing side effects. This study examined the use of EchoLaser Fusion guided laser ablation, a minimally invasive treatment that destroys cancer cells with heat, comparing two methods: one with fiducial markers, which help doctors precisely target the tumor, and one without. The results showed that patients who received fiducial markers had better treatment success, fewer recurrences, and shorter procedure times. These findings suggest that fiducial-assisted laser therapy may improve the accuracy and effectiveness of focal prostate cancer treatment, helping to refine non-surgical treatment options and offering men a safer, more precise alternative to traditional therapies.

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.