pT1 penile squamous cell carcinoma: A clinicopathologic study of 56 cases treated by CO 2 laser therapy

OBJECTIVE: To evaluate the pathologic characteristics that are associated with outcomes in pT1 penile squamous cell carcinoma (SCC) treated with laser excision. STUDY DESIGN: Peniscopic magnification and 5% acetic acid application were performed prior to CO ₂ laser excision. Specimens were reviewed to reassess stage, grade, invasion depth, carcinoma in situ, margins, tumor extension, lymphovascular invasion and human papillomavirus infection. Association between local recurrence (LR) and prognostic factors was established with Fisher exact test, χ ² test for categorical variables and Wilcoxon rank sum test for continuous variables. RESULTS: After a median follow-up of 66 months, 53 of 56 patients were alive and disease free; 3 died of unrelated and intercurrent diseases. Thirteen had an LR, with 4 experiencing multiple recurrences and 1 needing a partial amputation. Two patients had inguinal nodal metastasis in 1 node. LR had a positive correlation with positive surgical margins and depth of invasion and a negative correlation with tumor extension. CONCLUSION: Histopathologic parameters such as margin status, depth of invasion and tumor extension are predictors of LR in T1 penile SCC treated by CO ₂ laser excision. A logistic model could estimate each patient's risk of LR.