Thulium-yttrium-aluminium-garnet (Tm:YAG) laser treatment of penile cancer: oncological results, functional outcomes, and quality of life

Gennaro Musi, Andrea Russo, Andrea Conti, Francesco A Mistretta, Ettore Di Trapani, Stefano Luzzago, Roberto Bianchi, Giuseppe Renne, Stefano Ramoni, Matteo Ferro, Deliu Victor Matei, Marco Cusini, Luca Carmignani, Ottavio de Cobelli

Research output: Contribution to journalArticle

Abstract

PURPOSE: To evaluate the oncological and functional outcomes of patients diagnosed with penile cancer undergoing conservative treatment through thulium-yttrium-aluminium-garnet (Tm:YAG) laser ablation.

METHODS: Twenty-six patients with a penile lesion underwent ablation with a RevoLix 200 W continuous-wave laser. The procedure was carried out with a pen-like laser hand piece, using a 360 μm laser fiber and 15-20 W of power. Median (IQR) follow-up time was 24 (15-30) months. Recurrence rate and post-operative sexual function were assessed.

RESULTS: Median age at surgery was 61 years. Median (inter quartile range) size of the lesions was 15 [10-20] mm. Overall, 11 (47.8%) and 12 (52.2%) at the final pathology presented in situ and invasive squamous cell carcinoma (SCC), respectively. The final pathological stage was pTis, pT1a, pT2, and pT3 in 11 (47.8%), 7 (30.4%), 3 (13.0%), and 2 (8.7%) patients, respectively. Moreover, four (17.4%) patients had a recurrence of which three (13.0%) and one (4.3%) patients developed an invasive or in situ recurrence, respectively. After treatment 6 (26.1%) patients reported a conserved penile sensitivity, while 13 (56.5%) and 4 (17.4%) patients experienced a better or worse sensitivity after ablation, respectively. Post-treatment sexual activity was achieved within the first month after laser ablation in 82.6% of the patients.

CONCLUSION: Early stage penile carcinomas can be effectively treated with an organ preservation strategy. Tm:YAG conservative laser treatment is easy, safe and offers good functional outcome, with a minor impact on patient's quality of life.

Original languageEnglish
Pages (from-to)265-270
Number of pages6
JournalWorld Journal of Urology
Volume36
Issue number2
DOIs
Publication statusPublished - Feb 2018

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Thulium
Penile Neoplasms
Solid-State Lasers
Quality of Life
Lasers
Therapeutics
Laser Therapy
Recurrence
Organ Preservation
Sexual Behavior
Squamous Cell Carcinoma
Hand

Keywords

  • Aged
  • Aluminum
  • Carcinoma in Situ/pathology
  • Carcinoma, Squamous Cell/pathology
  • Humans
  • Laser Therapy/methods
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Penile Erection
  • Penile Neoplasms/pathology
  • Quality of Life
  • Sexual Health
  • Thulium
  • Treatment Outcome
  • Yttrium

Cite this

@article{42825e8c9b1149d2953a00cf115a5056,
title = "Thulium-yttrium-aluminium-garnet (Tm:YAG) laser treatment of penile cancer: oncological results, functional outcomes, and quality of life",
abstract = "PURPOSE: To evaluate the oncological and functional outcomes of patients diagnosed with penile cancer undergoing conservative treatment through thulium-yttrium-aluminium-garnet (Tm:YAG) laser ablation.METHODS: Twenty-six patients with a penile lesion underwent ablation with a RevoLix 200 W continuous-wave laser. The procedure was carried out with a pen-like laser hand piece, using a 360 μm laser fiber and 15-20 W of power. Median (IQR) follow-up time was 24 (15-30) months. Recurrence rate and post-operative sexual function were assessed.RESULTS: Median age at surgery was 61 years. Median (inter quartile range) size of the lesions was 15 [10-20] mm. Overall, 11 (47.8{\%}) and 12 (52.2{\%}) at the final pathology presented in situ and invasive squamous cell carcinoma (SCC), respectively. The final pathological stage was pTis, pT1a, pT2, and pT3 in 11 (47.8{\%}), 7 (30.4{\%}), 3 (13.0{\%}), and 2 (8.7{\%}) patients, respectively. Moreover, four (17.4{\%}) patients had a recurrence of which three (13.0{\%}) and one (4.3{\%}) patients developed an invasive or in situ recurrence, respectively. After treatment 6 (26.1{\%}) patients reported a conserved penile sensitivity, while 13 (56.5{\%}) and 4 (17.4{\%}) patients experienced a better or worse sensitivity after ablation, respectively. Post-treatment sexual activity was achieved within the first month after laser ablation in 82.6{\%} of the patients.CONCLUSION: Early stage penile carcinomas can be effectively treated with an organ preservation strategy. Tm:YAG conservative laser treatment is easy, safe and offers good functional outcome, with a minor impact on patient's quality of life.",
keywords = "Aged, Aluminum, Carcinoma in Situ/pathology, Carcinoma, Squamous Cell/pathology, Humans, Laser Therapy/methods, Male, Middle Aged, Neoplasm Recurrence, Local, Penile Erection, Penile Neoplasms/pathology, Quality of Life, Sexual Health, Thulium, Treatment Outcome, Yttrium",
author = "Gennaro Musi and Andrea Russo and Andrea Conti and Mistretta, {Francesco A} and {Di Trapani}, Ettore and Stefano Luzzago and Roberto Bianchi and Giuseppe Renne and Stefano Ramoni and Matteo Ferro and Matei, {Deliu Victor} and Marco Cusini and Luca Carmignani and {de Cobelli}, Ottavio",
year = "2018",
month = "2",
doi = "10.1007/s00345-017-2144-z",
language = "English",
volume = "36",
pages = "265--270",
journal = "World Journal of Urology",
issn = "0724-4983",
publisher = "Springer Verlag",
number = "2",

}

TY - JOUR

T1 - Thulium-yttrium-aluminium-garnet (Tm:YAG) laser treatment of penile cancer

T2 - oncological results, functional outcomes, and quality of life

AU - Musi, Gennaro

AU - Russo, Andrea

AU - Conti, Andrea

AU - Mistretta, Francesco A

AU - Di Trapani, Ettore

AU - Luzzago, Stefano

AU - Bianchi, Roberto

AU - Renne, Giuseppe

AU - Ramoni, Stefano

AU - Ferro, Matteo

AU - Matei, Deliu Victor

AU - Cusini, Marco

AU - Carmignani, Luca

AU - de Cobelli, Ottavio

PY - 2018/2

Y1 - 2018/2

N2 - PURPOSE: To evaluate the oncological and functional outcomes of patients diagnosed with penile cancer undergoing conservative treatment through thulium-yttrium-aluminium-garnet (Tm:YAG) laser ablation.METHODS: Twenty-six patients with a penile lesion underwent ablation with a RevoLix 200 W continuous-wave laser. The procedure was carried out with a pen-like laser hand piece, using a 360 μm laser fiber and 15-20 W of power. Median (IQR) follow-up time was 24 (15-30) months. Recurrence rate and post-operative sexual function were assessed.RESULTS: Median age at surgery was 61 years. Median (inter quartile range) size of the lesions was 15 [10-20] mm. Overall, 11 (47.8%) and 12 (52.2%) at the final pathology presented in situ and invasive squamous cell carcinoma (SCC), respectively. The final pathological stage was pTis, pT1a, pT2, and pT3 in 11 (47.8%), 7 (30.4%), 3 (13.0%), and 2 (8.7%) patients, respectively. Moreover, four (17.4%) patients had a recurrence of which three (13.0%) and one (4.3%) patients developed an invasive or in situ recurrence, respectively. After treatment 6 (26.1%) patients reported a conserved penile sensitivity, while 13 (56.5%) and 4 (17.4%) patients experienced a better or worse sensitivity after ablation, respectively. Post-treatment sexual activity was achieved within the first month after laser ablation in 82.6% of the patients.CONCLUSION: Early stage penile carcinomas can be effectively treated with an organ preservation strategy. Tm:YAG conservative laser treatment is easy, safe and offers good functional outcome, with a minor impact on patient's quality of life.

AB - PURPOSE: To evaluate the oncological and functional outcomes of patients diagnosed with penile cancer undergoing conservative treatment through thulium-yttrium-aluminium-garnet (Tm:YAG) laser ablation.METHODS: Twenty-six patients with a penile lesion underwent ablation with a RevoLix 200 W continuous-wave laser. The procedure was carried out with a pen-like laser hand piece, using a 360 μm laser fiber and 15-20 W of power. Median (IQR) follow-up time was 24 (15-30) months. Recurrence rate and post-operative sexual function were assessed.RESULTS: Median age at surgery was 61 years. Median (inter quartile range) size of the lesions was 15 [10-20] mm. Overall, 11 (47.8%) and 12 (52.2%) at the final pathology presented in situ and invasive squamous cell carcinoma (SCC), respectively. The final pathological stage was pTis, pT1a, pT2, and pT3 in 11 (47.8%), 7 (30.4%), 3 (13.0%), and 2 (8.7%) patients, respectively. Moreover, four (17.4%) patients had a recurrence of which three (13.0%) and one (4.3%) patients developed an invasive or in situ recurrence, respectively. After treatment 6 (26.1%) patients reported a conserved penile sensitivity, while 13 (56.5%) and 4 (17.4%) patients experienced a better or worse sensitivity after ablation, respectively. Post-treatment sexual activity was achieved within the first month after laser ablation in 82.6% of the patients.CONCLUSION: Early stage penile carcinomas can be effectively treated with an organ preservation strategy. Tm:YAG conservative laser treatment is easy, safe and offers good functional outcome, with a minor impact on patient's quality of life.

KW - Aged

KW - Aluminum

KW - Carcinoma in Situ/pathology

KW - Carcinoma, Squamous Cell/pathology

KW - Humans

KW - Laser Therapy/methods

KW - Male

KW - Middle Aged

KW - Neoplasm Recurrence, Local

KW - Penile Erection

KW - Penile Neoplasms/pathology

KW - Quality of Life

KW - Sexual Health

KW - Thulium

KW - Treatment Outcome

KW - Yttrium

U2 - 10.1007/s00345-017-2144-z

DO - 10.1007/s00345-017-2144-z

M3 - Article

C2 - 29197968

VL - 36

SP - 265

EP - 270

JO - World Journal of Urology

JF - World Journal of Urology

SN - 0724-4983

IS - 2

ER -