Office-based targeted laser ablation for prostate cancer: Technique and early outcomes based on NCCN risk stratification

Introduction Office-based targeted laser ablation (OTLA) is an innovative, minimally invasive treatment for prostate cancer that combines precision with functional preservation. Utilizing transrectal ultrasound (TRUS) with enhanced flow imaging, this video highlights the OTLA technique, its adaptability across National Comprehensive Cancer Network (NCCN) risk categories, and its outcomes in an outpatient setting. Methods Sixty-three OTLA procedures were performed using the Tranberg CLS laser system and TRUS guidance between May 2023 and October 2024. Patients underwent treatment under intravenous sedation with careful neurovascular preservation and real-time ablation zone monitoring. Post-procedural assessments included follow-up biopsies and functional outcomes. Results Early outcomes demonstrated PSA reductions across all risk groups and low recurrence rates in low- and intermediate-risk patients. Postoperative complications were minimal, with 8.3% reporting erectile dysfunction and no urinary incontinence observed. Conclusion OTLA offers a safe, effective, and accessible alternative to traditional prostate cancer therapies, positioning it as a promising outpatient option.