Not provided
| ID | Type | Description | Link |
|---|---|---|---|
| 364428 | Other Identifier | IRAS NIHR |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
The goal of this study is to find out whether a new method called "LaserSAFE" can accurately detect cancer at the edge of the prostate (called a positive margin) during prostate surgery. LaserSAFE uses a special microscope in the operating room to quickly scan the prostate after it has been removed from the body. This information can help surgeons decide whether it is safe to preserve the nerves around the prostate. This is especially important for patients who are not usually considered suitable for nerve-sparing surgery using current methods. The study will also assess how quickly and reliably LaserSAFE provides this information during surgery.
The main questions it aims to answer are:
Can LaserSAFE accurately detect cancer at the edges of the prostate during surgery? Can LaserSAFE help surgeons safely decide whether to preserve or remove the surrounding nerves?
Researchers will evaluate the use of the LaserSAFE technique during surgery to see if it improves decision-making about nerve preservation compared to standard practice.
Participants will:
Complete a quality of life questionnaire before surgery Undergo standard prostate surgery, where the surgeon will initially try to preserve the nerves Have their removed prostate analysed during surgery using the LaserSAFE technique Have additional tissue removed if LaserSAFE detects cancer at the edges of the prostate Attend routine follow-up visits as part of standard care Complete quality of life questionnaires at 3 and 12 months after surgery
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| LaserSAFE | Diagnostic Test | The LaserSAFE intervention uses the Histolog® fluorescence confocal microscope to provide real-time tissue visualization at near-cellular resolution. The CE/UKCA/FDA-approved system uses non-ionizing 488nm laser light to capture high-resolution images of areas up to 48×36mm in approximately 60 seconds. Specimen preparation involves cleaning the excised prostate, staining with Histolog Dip® solution for 10 seconds, rinsing with saline, and positioning on the scanner. Both posterolateral surfaces are imaged sequentially, with total acquisition under 5 minutes before standard formalin processing. Image interpretation by trained pathologists identifies positive surgical margins (PSMs), documenting margin dimensions and multifocality. Findings are communicated intraoperatively to guide nerve preservation decisions. Secondary resection of the ipsilateral neurovascular bundle is performed when posterolateral PSMs exceed 3mm (single margin) or multiple PSMs are detected. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity | Sensitivity of LaserSAFE to detect positive margins in the posterolateral area of the prostate of more than 3 mm compared against final paraffin analysis Sensitivity will be monitored across the trial when the first 150, 300 and 500 participants have been recruited. If sensitivity decreases below 85%, trial methodology will be reviewed and if considered appropriate the trial will be stopped. | 12 months |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy metrics for any size of positive margin | Overall sensitivity, specificity, PPV and NPV of LaserSAFE compared to FFPE analysis for any length of PSM | 12 months |
| Determination of Margin Length Cut-off for Secondary Resection |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Not provided
Not provided
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Ricardo Almeida-Magana, Dr | Contact | +44 02076792000 | r.magana@ucl.ac.uk |
| Name | Affiliation | Role |
|---|---|---|
| Greg Shaw, Professor | University College, London | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University College London Hospital NHS Foundation Trust | Recruiting | London | NW1 2BU | United Kingdom |
An anonymised dataset will be made available on a case by case basis to researchers
Not provided
Not provided
Not provided
Not provided
| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Jan 14, 2026 | Apr 14, 2026 | Prot_000.pdf |
Not provided
| ID | Term |
|---|---|
| D011471 | Prostatic Neoplasms |
| D000230 | Adenocarcinoma |
| D000072662 | Margins of Excision |
| ID | Term |
|---|---|
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
Not provided
Not provided
| ID | Term |
|---|---|
| D018613 | Microscopy, Confocal |
| ID | Term |
|---|---|
| D008853 | Microscopy |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
Not provided
Not provided
This trial will be a multi-site, prospective, non-randomised cohort study focused on accuracy
Not provided
Not provided
Not provided
The study will evaluate the optimal cut-off for positive margin length that should trigger a secondary resection, with the aim of maximising nerve-sparing without compromising oncological safety
| 12 months |
| Accuracy metrics for positive margins more than 3 mm | Overall specificity, PPV and NPV of LaserSAFE compared to FFPE analysis for any PSM > 3 mm. | 12 months |
| Residual prostate cancer rate | Rate of residual prostate cancer in secondary resections of the neurovascular bundle | 12 months |
| Rate of positive margins | Prevalence of PSM detected by paraffin analysis in the overall cohort | 12 months |
| Biochemical failure | Prevalence of prostate cancer biochemical recurrence or salvage treatment within 12 months after surgery | 12 months |
| EPIC-26 urinary incontinence mean score | Mean score for EPIC-26 urinary incontinence domain at baseline, 3 and 12 months after surgery Expanded Prostate Cancer Index Composite (EPIC)-26, is a 26-item patient reported outcome, is a continuous scale ranging from 0 to 100, with higher scores indicating better function | 12 months |
| EPIC-26 erectile function mean score | Mean score for EPIC-26 erectile function domain at baseline, 3 and 12 months after surgery Expanded Prostate Cancer Index Composite (EPIC)-26, is a 26-item patient reported outcome, is a continuous scale ranging from 0 to 100, with higher scores indicating better function | 12 months |
| D005832 |
| Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D065308 | Morphological and Microscopic Findings |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008919 |
| Investigative Techniques |