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

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.

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.

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.

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.

World journal of urology. 2017 Dec 02 [Epub ahead of print]

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

Department of Urology, Istituto Europeo di Oncologia, Via Ripamonti 435, Milan, Italy., Department of Urology, Istituto Europeo di Oncologia, Via Ripamonti 435, Milan, Italy. ., Department of Pathology, Istituto Europeo di Oncologia, Via Ripamonti 435, Milan, Italy., Department of Dermatology, Fondazione Ca' Granda IRCCS Policlinico, Via Pace 9, Milan, Italy., Department of Urology, IRCCS Policlinico San Donato, Piazza Malan 1, San Donato Milanese, Italy.

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