title: Treatment of Carcinoma In Situ of the Glans Penis With Topical Imiquimod Followed by Carbon Dioxide Laser Excision.
abstract: Different approaches have been described in published studies for carcinoma in situ (CIS) of the glans penis (erythroplasia of Queyrat), including topical chemotherapy or immunotherapy and laser or surgical excision. We evaluated the efficacy of topical imiquimod (IQ) followed by carbon dioxide laser ablation of the lesion.
  
  
  
  From 2010 to 2015, 10 patients affected by CIS of the glans were treated by IQ, followed by carbon dioxide laser ablation. For every patient, we performed histologic examination before and after IQ. Local toxicity and adverse effects were recorded.
  
  
  
  After treatment, histologic examination showed no residual tumor in 6 patients (complete response [CR]), stable disease in 2 patients, and progressive disease in 2 patients. Those with a CR had human papillomavirus-related lesions, and they had no experienced relapses after a mean follow-up of 26 months. The 2 patients with progressive disease underwent total penectomy. All patients were alive at the last follow-up examination. All patients experienced a mild local toxicity (burning erythema) but no major adverse effects.
  
  
  
  Local treatment with IQ for glans CIS is effective mainly for human papillomavirus-related lesions. The present study is the first to record the histologic examination findings before and after IQ treatment. The small number of patients, owing to the rarity of this disease, was the main limitation of the present study. IQ must be used carefully, and a close follow-up protocol is mandatory because of the lack of long-term efficacy data.
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy. Electronic address: tulliotorelli@gmail.com.
authors.forename: Tullio
authors.initials: T
authors.lastname: Torelli
authors.affiliation: IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Mario A
authors.initials: MA
authors.lastname: Catanzaro
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Nicolai
authors.affiliation: Department of Medical Oncology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Giannatempo
authors.affiliation: Department of Medical Oncology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Necchi
authors.affiliation: Department of Medical Oncology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Raggi
authors.affiliation: Department of Pathology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Biagio
authors.initials: B
authors.lastname: Paolini
authors.affiliation: Department of Pathology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Colecchia
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Piva
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Biasoni
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stagni
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tesone
authors.affiliation: Department of Urology, IRCCS Fondazione, Istituto Nazionale dei Tumori, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Salvioni
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000634:Aminoquinolines / Q000008:administration & dosage* / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002278:Carcinoma in Situ / Q000628:therapy* / Q000821:virology; D018572:Disease-Free Survival; D006801:Humans; D000077271:Imiquimod; D054020:Lasers, Gas / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000628:therapy; D010412:Penile Neoplasms / Q000628:therapy* / Q000821:virology; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000634:Aminoquinolines; D000970:Antineoplastic Agents; D000077271:Imiquimod
keywords: Erythroplasia of Queyrat; HPV-related carcinoma; Laser therapy; Penile CIS; Penile carcinoma; Topical immunotherapy