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 -