Penile Superficial Squamous cell Carcinoma (SCC) Submitted to CO2 Laser Excision only: Oncologic Outcome of T1 Disease in 25 Years-Long Experience

26/2007

Penile Superficial Squamous cell Carcinoma (SCC) Submitted to CO2 Laser Excision only: Oncologic Outcome of T1 Disease in 25 Years-Long Experience

Wednesday 12th December 2007

Colecchia, Maurizio; Nicolai, Nicola; Secchi, Piercesare; Bandieramonte, Gaetano; Paganoni, Anna M.; Sangalli , Laura M.; Piva, Luigi; Salvioni, Roberto

1. Purpose. We retrospectively identified patients with ascertained T1 SCC pf the penis who were submitted to laser excision only, in order to evaluate clinical and pathological characteristics which can associate with outcomes. 2. Materials and Methods. Peniscopic magnification and 5% acetic acid application were performed for diagnosis and prior to CO2 laser excision. Only naïve patients with no urethral (> 5 mm from the meatus) neither shaft lesions were considered. Specimens were all reviewed in order to reassess pathological characteristics: stage, grade, invasion depth, carcinoma in situ, margins, tumor extension, lymphovascular invasion and HPV infection. Association between local recurrence (LR) and prognostic factors was ascertained with Fisher exact test and ChiSquare test for categorical variables and Wilcoxon rank sum test for continuous variables. 3. Results. A total of 56 pT1 stage patients were identified. After a median followup of 66 months (range: 12256), 53 patients are alive and disease free, whereas 3 died of unrelated and intercurrent diseases. Thirteen (23.21%) had a LR, with 4 suffering multiple recurrences and 1 needing a partial amputation 30 months following primary excision. Only 2 (3.57%) patients had inguinal nodal metastasis in one node. LR had a positive correlation with positive microsurgical margins (onesided Fisher p value .0019) and depth of invasion and a negative correlation with tumor extension (onesided Wilcoxon p value of .0028 and .0054, respectively). A logistic regression model included margin status, depth of invasion, tumor extension and presence of CIS as significant variables. 4. Conclusions. CO2 laser excision of selected pT1 SCC of the penis is a highly reliable procedure which associates with excellent oncological and organsparing long term results. Predictive variables can be identified and a model that estimates the risk of this event could be adopted.

This report, or a modified version of it, has been also submitted to, or published on
Colecchia, M., et al., pT1 Penile Squamous Cell Carcinoma: A Clinicopathologic Study of 56 Cases Treated by CO2 Laser Therapy, Analytical and Quantitative Cytology and Histology, Vol. 31, No. 3, pp. 153-160 (2009)