Percutaneous Magnetic Resonance Imaging-Guided Focal Laser Ablation (MRI-FLA) of Prostate Tumors: A Systematic Review and Network Meta-Analysis

Abstract

Background/Objectives: MRI-guided focal laser ablation (MRI-FLA) is an emerging minimally invasive technique for treating localized prostate tumors, aiming to provide effective cancer control while minimizing side effects. This meta-analysis systematically evaluates the clinical outcomes, technical efficacy, and complication rates associated with MRI-FLA to better understand its therapeutic potential and safety profile in prostate cancer management. Methods: In July 2024, PubMed (MEDLINE) was searched for eligible trials using the PRISMA guidelines. The primary outcome was residual disease (RD). The secondary outcomes were technical efficacy, progression to metastatic disease, cancer-specific mortality, complications, and decreases in the prostate-specific antigen (PSA) level. Results: Nine clinical trials involving 296 patients with prostate tumors treated via MRI-FLA were analyzed. A random effects model showed that the overall RD prevalence after ablation was 20.37% (12.56–29.28%; p = 0.03) and the cancer-free survival rate was 75.62% (64.88–85.10%). The rate of major and minor adverse effects was 14.26% (0.61–37.3%, p < 0.01). Conclusions: MRI-FLA is safe, feasible, and effective, although further trials are required.