Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up

Authors

  • Boris Schlenker,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Derya Tilki,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Michael Seitz,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Markus J. Bader,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Oliver Reich,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Peter Schneede,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Edwin Hungerhuber,

    1. Department of Urology, Hospital Muehldorf, Muehldorf, Germany
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  • Christian G. Stief,

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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  • Christian Gratzke

    1. Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Department of Urology, Hospital Memmingen, Memmingen, and
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Boris Schlenker, Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians-University Munich, Marchioninistr. 15, 81377 Munich, Germany.
e-mail: boris.schlenker@med.uni-muenchen.de

Abstract

Study Type – Therapy (case series)
Level of Evidence 4

OBJECTIVE

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.

RESULTS

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.

CONCLUSIONS

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.

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