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World J Urol. 2018 Feb;36(2):265-270. doi: 10.1007/s00345-017-2144-z. Epub 2017 Dec 2.

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

Author information

1
Department of Urology, Istituto Europeo di Oncologia, Via Ripamonti 435, Milan, Italy.
2
Department of Urology, Istituto Europeo di Oncologia, Via Ripamonti 435, Milan, Italy. andrea.russo@ieo.it.
3
Department of Pathology, Istituto Europeo di Oncologia, Via Ripamonti 435, Milan, Italy.
4
Department of Dermatology, Fondazione Ca' Granda IRCCS Policlinico, Via Pace 9, Milan, Italy.
5
Department of Urology, IRCCS Policlinico San Donato, Piazza Malan 1, San Donato Milanese, Italy.
6
Università degli Studi di Milano, Via Festa del Perdono 7, Milan, Italy.

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:

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

PMID:
29197968
DOI:
10.1007/s00345-017-2144-z
[Indexed for MEDLINE]

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