Treatment of Carcinoma in Situ of the Glans Penis with Topical Imiquimod Followed by CO2 Laser Excision

Abstract Background different approaches are described in literature for carcinoma in situ (CIS) of the glans penis (Erythroplasia of Queyrat, EQ): topical chemotherapy or immunotherapy, laser or surgical exicision. We evaluated the efficacy of topical Imiquimod (IQ) followed by dioxide laser ablati...

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Bibliographic Details
Published in:Clinical genitourinary cancer 2017
Main Authors: Torelli, Tullio, M.D, Catanzaro, Mario A., MD, Nicolai, Nicola, MD, Giannatempo, Patrizia, MD, Necchi, andrea, MD, Raggi, Daniele, MD, Paolini, Biagio, MD, Colecchia, Maurizio, MD, Piva, Luigi, MD, Biasoni, Davide, Stagni, Silvia, MD, Tesone, Antonio, MD, Salvioni, Roberto, MD
Format: Article
Language:English
Subjects:
Hematology, Oncology and Palliative Medicine
Urology
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Summary:Abstract Background different approaches are described in literature for carcinoma in situ (CIS) of the glans penis (Erythroplasia of Queyrat, EQ): topical chemotherapy or immunotherapy, laser or surgical exicision. We evaluated the efficacy of topical Imiquimod (IQ) followed by dioxide laser ablation of the lesion. Patients and methods from 2010 to 2015 ten patients affected by CIS of the glans were treated by IQ followed by lesion’s dioxide laser ablation. In every patient we performed histological examination before and after IQ. Local toxicity and adverse effects were recorded. Results after treatment, histological examination showed no residual tumour in six patients (complete responder - CR), stable disease in two patients and progressive disease in two patients. CRs had HPV related lesions and they had no relapses after a mean follow up of 26 months, while two patients with progressive disease underwent total penectomy. All patients are alive at last follow up. In all patients we recorded a mild local toxicity (burning erythema) but no major adverse effects. Conclusions local treatment with IQ in glans CIS is effective mainly in HPV related lesions. This is the first study to record histological examination before and after IQ treatment. The small number of patients due to the rarity of this disease is the main limitation of the study. IQ must be used carefully and a close follow up is mandatory, also due to the lack of long term efficacy data.
ISSN:1558-7673
DOI:10.1016/j.clgc.2017.01.009