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

2 Citations (Scopus)

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 - 2018

Fingerprint

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

Keywords

  • Conservative treatment
  • Penile cancer
  • Quality of life
  • Sexual function
  • Thulium–yttrium–aluminium–garnet laser
  • Tm:YAG

ASJC Scopus subject areas

  • Urology

Cite this

Thulium–yttrium–aluminium–garnet (Tm : YAG) laser treatment of penile cancer: oncological results, functional outcomes, and quality of life. / Musi, Gennaro; Russo, Andrea; Conti, Andrea; Mistretta, Francesco A.; Di Trapani, Ettore; Luzzago, Stefano; Bianchi, Roberto; Renne, Giuseppe; Ramoni, Stefano; Ferro, Matteo; Matei, Deliu Victor; Cusini, Marco; Carmignani, Luca; de Cobelli, Ottavio.

In: World Journal of Urology, Vol. 36, No. 2, 2018, p. 265-270.

Research output: Contribution to journalArticle

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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.",
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T2 - YAG) laser treatment of penile cancer: 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

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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.

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KW - Quality of life

KW - Sexual function

KW - Thulium–yttrium–aluminium–garnet laser

KW - Tm:YAG

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