MP61-17 ORGAN PRESERVATION AND ONCOLOGICAL EFFICACY OF PENISCOPICALLY CONTROLLED CO2 LASER EXCISION OF PENILE SQUAMOUS CELL CARCINOMA: EARLY AND LATE RESULTS IN a HIGH-VOLUME CENTER

You have accessJournal of UrologyPenile & Testicular Cancer II (MP61)1 May 2024MP61-17 ORGAN PRESERVATION AND ONCOLOGICAL EFFICACY OF PENISCOPICALLY CONTROLLED CO2 LASER EXCISION OF PENILE SQUAMOUS CELL CARCINOMA: EARLY AND LATE RESULTS IN a HIGH-VOLUME CENTER Carlo Silvani, Vito Lorusso, Sebastiano Nazzani, Alberto Macchi, Tullio Torelli, Silvia Stagni, Antonio Tesone, Melanie Claps, Patrizia Giannatempo, Matteo Zimatore, Laura Cattaneo, Biagio Paolini, Ruggero Darisi, Davide Biasoni, Emanuele Montanari, Mario Catanzaro, and Nicola Nicolai Carlo SilvaniCarlo Silvani , Vito LorussoVito Lorusso , Sebastiano NazzaniSebastiano Nazzani , Alberto MacchiAlberto Macchi , Tullio TorelliTullio Torelli , Silvia StagniSilvia Stagni , Antonio TesoneAntonio Tesone , Melanie ClapsMelanie Claps , Patrizia GiannatempoPatrizia Giannatempo , Matteo ZimatoreMatteo Zimatore , Laura CattaneoLaura Cattaneo , Biagio PaoliniBiagio Paolini , Ruggero DarisiRuggero Darisi , Davide BiasoniDavide Biasoni , Emanuele MontanariEmanuele Montanari , Mario CatanzaroMario Catanzaro , and Nicola NicolaiNicola Nicolai View All Author Informationhttps://doi.org/10.1097/01.JU.0001009536.58867.87.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: To evaluate safety and early and long-term efficacy of CO2 laser conservative treatments for non-ulcerative squamous cell carcinoma (SCC) of the penis. METHODS: Within our institutional database (2002–2022, included), we identified 122 consecutive cT1-2 cN0 cM0 patients with penile SCC who underwent conservative CO2 laser treatments. Histologically confirmed local relapses were recorded. Local relapses were classified as early ecurrences when occurring 2 years after first laser treatment. Predictors of disease relapse were analyzed with univariable and multivariable Cox regression models (MCRMs). RESULTS: Median follow-up was 36 months Interquartile range (IQR) 21-73 months. Median age was 62 years (IQR: 51-69 years). Median largest lesion size was 10 mm (IQR 5-15 mm). Usual SCC (86.9%) was the most frequent histology followed by basaloid SCC (5.7%) and other SCC (7.4%). 62 patients had penile intraepithelial neoplasia (PeIN) (51.6%), 30 had pT1m (24.6 %), 28 had pT1 (23%) and one had pT2 (0.8%), two patients were classified as pTx. In case of infiltrative lesions, tumor Grade was G1 in 37 (60.7%), G2 in 20 (32.8%), G3 in 4 (6.5%). No immediate complications were recorded. Four patients experienced postoperative phimosis and one had meatal stenosis (Clavien Dindo >2 complications: 4.1%). After first excision, 25 patients (20.5 %) underwent radicalization, due to positive margins or aggressive disease. During the follow up 49 patients had recurrent disease. Early and late recurrences occurred in 28 (22%) and in 21 patients (18%), respectively. Recurrences were treated with new CO2 laser excision in 39 (80%), partial amputation in 8 (16%), glansectomy and circumcision (2%) in one patient each (2%). Proportion of penis preservation was 93.4% and 92.6% at 2 and 5 years. Independent predictors of overall and early recurrences were not identified at MCRMs. Conversely, pT1 stage Hazard Ratio (HR) 13, Confidence Interval (CI) 1.4–73, p-value 0.02 and flat lesions (HR 7.9, CI 1.06–59, 0.04) achieved independent predictor status for late recurrences. Finally, two patients developed inguinal nodal disease during follow-up. No cancer related deaths were recorded after a median follow-up of 36 months. CONCLUSIONS: As far as we know, this is the largest cohort of patients with penile cT1-T2 SCC who underwent conservative CO2 laser treatment. Although recurrences were as frequent as 40% in a time span of three years, the vast majority (92%) of these patients preserved their organ at 5 years. Some factors can be of use in preventing or anticipating late recurrences. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1018 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Carlo Silvani More articles by this author Vito Lorusso More articles by this author Sebastiano Nazzani More articles by this author Alberto Macchi More articles by this author Tullio Torelli More articles by this author Silvia Stagni More articles by this author Antonio Tesone More articles by this author Melanie Claps More articles by this author Patrizia Giannatempo More articles by this author Matteo Zimatore More articles by this author Laura Cattaneo More articles by this author Biagio Paolini More articles by this author Ruggero Darisi More articles by this author Davide Biasoni More articles by this author Emanuele Montanari More articles by this author Mario Catanzaro More articles by this author Nicola Nicolai More articles by this author Expand All Advertisement PDF downloadLoading ...