title: Organ-preserving neodymium-yttrium-aluminium-garnet laser therapy for penile carcinoma: a long-term follow-up.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Urology, University Hospital Grosshadern, Ludwig-Maximilians University, Munich, Germany. boris.schlenker@med.uni-muenchen.de
authors.forename: Boris
authors.initials: B
authors.lastname: Schlenker
authors.forename: Derya
authors.initials: D
authors.lastname: Tilki
authors.forename: Michael
authors.initials: M
authors.lastname: Seitz
authors.forename: Markus J
authors.initials: MJ
authors.lastname: Bader
authors.forename: Oliver
authors.initials: O
authors.lastname: Reich
authors.forename: Peter
authors.initials: P
authors.lastname: Schneede
authors.forename: Edwin
authors.initials: E
authors.lastname: Hungerhuber
authors.forename: Christian G
authors.initials: CG
authors.lastname: Stief
authors.forename: Christian
authors.initials: C
authors.lastname: Gratzke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004812:Epidemiologic Methods; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009354:Neodymium; D009364:Neoplasm Recurrence, Local; D010412:Penile Neoplasms / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009354:Neodymium