Penile carcinoma. Is Nd:YAG laser therapy radical enough?

PURPOSE: Penile carcinoma is a difficult disease to treat due to its aggressive nature and the psychological effects of amputation, which is often the recommended therapy. Outcome data from the last 13 years on patients with penile carcinoma treated with Nd:YAG laser coagulation were evaluated and compared with outcome data on conventional organ sparing techniques.

MATERIALS AND METHODS: For the last 13 years 29 patients were treated with Nd:YAG laser coagulation, including 17 with carcinoma in situ, and 10 with stage T1 and 2 with T2 cancer. Mean patient age was 55.1 years and mean followup was 46.7 months.

RESULTS: All patients are alive. Disease recurred in 1 patient with T1 tumor and 1 with carcinoma in situ. All patients were satisfied with the cosmetic and functional result.

CONCLUSIONS: Recurrence rates after Nd:YAG laser treatment for T1 tumors are comparable to those after partial amputation. Excellent cosmetic and functional results can be achieved without compromising oncological principles. For patients with metastasis prognosis is limited by the distant disease and, therefore, amputation is only necessary to achieve local control.