Neodymium-YAG laser treatment in localized prostatic cancer. High rate of local failure

Clinically localized prostatic cancer, T0-2,NX,M0, was treated with extended transurethral resection and subsequent neodymium-YAG laser irradiation of the prostatic cavity in 20 patients in 1987-1990. The patients' mean age was 71 (range 64-84) years. During 12-month follow-up only three patients had negative biopsies, whereas 16 had residual cancer and one had atypical, suspectedly malignant cells. Eight of the 16 with residual cancer underwent repetition of the combined resection and laser treatment, but this led to negative biopsies in only two cases. The treatment per se was well tolerated and side effects were few, but the poor outcome concerning local tumor control is contradictory to previous reports and raises doubts as to the advisability of offering such treatment as an alternative to radical prostatectomy.