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| ID | Type | Description | Link |
|---|---|---|---|
| NL69903.018.19 | Other Identifier | Toetsingonline |
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| Name | Class |
|---|---|
| Elesta S.R.L. | INDUSTRY |
| Amsterdam UMC, location VUmc | OTHER |
| The Netherlands Cancer Institute | OTHER |
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Rationale: Prostate cancer (PCa) is the second cause of cancer-related deaths for men. The standard surgical treatment for localised prostate cancer is radical prostatectomy. Possible side effects of this treatment are incontinence and erectile dysfunction and this is related to the whole-gland resection. A focal treatment with fewer side effects is desired for patients with only a small focus of PCa. For this purpose, focal laser ablation is feasible. Current focal laser ablation techniques use a single fibre setup with the need for fibre replacement revisualisation of the tumour side accordingly. This leads to a long treatment duration.
The Echolaser® system is a laser ablation system with four simultaneously operating laser sources. This provides a potential larger treatment area, without the need for fibre replacement.
This makes the system advantageous for focal laser ablation of prostate cancer, especially since it can be applied under local anaesthesia.
This pilot study aims to evaluate histological ablative efficacy on radical prostatectomy specimens following TPLA, feasibility and safety using a (multi)fibre setup in men with localized prostate cancer. The investigators hypothesize that TPLA will show adequate histological ablative efficacy and will be feasible and safe.
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Echolaser X4 system | Device | Transperineal laser ablation |
| Measure | Description | Time Frame |
|---|---|---|
| Ablative efficacy of transperineal laser ablation determined by size of the ablation zone in histopathology, which is measured by absence of vital prostatic cells, compared to the size measured on imaging (CEUS/MRI) during and after treatment | Histological ablative efficacy is assessed on histopathological analysis of the prostatic tissue after radical prostatectomy by means of the absence of vital cells in the treated prostate zone | 30 days following TPLA treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Safety is assessed by device and procedural adverse events using the CTCAEv5.0 until radical prostatectomy and feasibility is determined by procedural success of the TPLA treatment. | Safety is assessed by device and procedural adverse events using the CTCAE v5.0 until radical prostatectomy. TPLA is definitely safe when ≤10% of patients experience major adverse events, defined as grade 3 or higher. Technical feasibility is determined by procedural success of the TPLA treatment. TPLA is definitely feasible when ≥90% of procedures is performed successfully without any problems regarding needle placement, fibre introduction or device malfunctioning. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| J R Oddens, MD, PhD | Urologist | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Academic Medical Center | Amsterdam | North Holland | 1105AZ | Netherlands |
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| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| 30 days following TPLA treatment |
| Size of ablation zone | Determination of the size of the ablated area | 30 days following TPLA treatment |
| Observation of tissue changes seen on imaging during and after treatment compared to histopathology | Ablation zone volumes are measured using CEUS and mpMRI and these are used to determine ablation zone compared to histopathological changes. Visual changes are identified and described. | 30 days following TPLA treatment |
| Functional outcomes measured using PROMs (VAS, IPSS, IIEF-15, EPIC) | Determination of short-term functional outcomes following TPLA treatment | 30 days following TPLA treatment |
| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |