Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up
Article first published online: 26 AUG 2010
© 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL
Volume 106, Issue 6, pages 786–790, September 2010
How to Cite
Schlenker, B., Tilki, D., Seitz, M., Bader, M. J., Reich, O., Schneede, P., Hungerhuber, E., Stief, C. G. and Gratzke, C. (2010), Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up. BJU International, 106: 786–790. doi: 10.1111/j.1464-410X.2009.09188.x
- Issue published online: 26 AUG 2010
- Article first published online: 26 AUG 2010
- Accepted for publication 6 October 2009
- penile cancer;
- squamous cell carcinoma;
- organ preserving therapy;
- laser therapy
Study Type – Therapy (case series) Level of Evidence 4
To retrospectively analyse the long-term follow-up of 54 patients treated with organ-preserving laser therapy for penile carcinoma, as such therapy provides excellent cosmetic and functional results, but recurrence rates are high, which might impair the oncological outcome and worsen tumour-related survival.
PATIENTS AND METHODS
Between 1979 and 2008, 54 patients with penile carcinoma were treated with the neodymium-doped yttrium-aluminium-garnet (Nd:YAG) laser at our institution; 11 were classified as having carcinoma in situ (Tis), 39 as T1 and four as T2.
There was local recurrence in 16 patients (42%); the mean (range) time to local recurrence was 53 (9–132) months. In half the patients the time to local recurrence was >53 months, with the latest recurrence at 132 months after initial therapy of primary tumour. There was no statistically significant difference in recurrence rates with Tis or invasive penile carcinoma. In lymph-node-negative patients at initial presentation, there were no newly developed positive lymph nodes during the follow-up.
Organ-preserving laser therapy showed a relatively high recurrence rate in patients with a long-term follow up, but the oncological outcome and survival were not compromised by local recurrence. Therefore, laser therapy appears to be appropriate for treating premalignant lesions and early stages of penile carcinoma. Patients should be informed about the potential for late recurrence.