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World Journal of Urology

, Volume 36, Issue 2, pp 265–270 | Cite as

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

  • Gennaro Musi
  • Andrea RussoEmail author
  • 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
Original Article

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

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

Notes

Author contributions

GM: project development and manuscript writing. AR: project development, manuscript writing, analysis, and interpretation of the data. AC: data collection, project development, and manuscript writing. FAM: data collection and project development. ET: project development and manuscript writing. SL: analysis and interpretation of the data. RB: data collection. GR: data collection. SR: data collection. MF: project development and manuscript editing. DVM: intellectual content. MC: data collection. LC: intellectual content and manuscript editing. OC: intellectual content and manuscript editing.

Compliance with ethical standards

Conflict of interest

Prof. Luca Carmignani has a scientific contract with Quanta System. The other authors declare no conflicts of interest, including specific financial interests or relationships or affiliations relevant to the subject matter or materials discussed in the manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Gennaro Musi
    • 1
  • Andrea Russo
    • 1
    Email author
  • Andrea Conti
    • 1
  • Francesco A. Mistretta
    • 1
  • Ettore Di Trapani
    • 1
  • Stefano Luzzago
    • 1
  • Roberto Bianchi
    • 1
  • Giuseppe Renne
    • 2
  • Stefano Ramoni
    • 3
  • Matteo Ferro
    • 1
  • Deliu Victor Matei
    • 1
  • Marco Cusini
    • 3
  • Luca Carmignani
    • 4
  • Ottavio de Cobelli
    • 1
    • 5
  1. 1.Department of UrologyIstituto Europeo di OncologiaMilanItaly
  2. 2.Department of PathologyIstituto Europeo di OncologiaMilanItaly
  3. 3.Department of DermatologyFondazione Ca’ Granda IRCCS PoliclinicoMilanItaly
  4. 4.Department of UrologyIRCCS Policlinico San DonatoSan Donato MilaneseItaly
  5. 5.Università degli Studi di MilanoMilanItaly

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