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Issa A, Sebro K, Kwok A, Janisch F, Grossmann NC, Lee E, Lucky M, Oliveira P, Lau M, Parnham A, Sangar V, Fankhauser CD. Treatment Options and Outcomes for Men with Penile Intraepithelial Neoplasia: A Systematic Review. Eur Urol Focus 2021; 8:829-832. [PMID: 33994168 DOI: 10.1016/j.euf.2021.04.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 04/18/2021] [Accepted: 04/29/2021] [Indexed: 11/29/2022]
Abstract
Penile intraepithelial neoplasia (PeIN) is a rare skin condition with potential to progress to invasive penile cancer. We performed a systematic review of treatment options and outcomes for PeIN. Topical agents showed response and recurrence rates of 40-100% and 20% for imiquimod, and 48-74% and 11% for 5-fluorouracil, respectively. Discontinuation of topical agents because of side effects was observed in 12% of cases. Response rates for laser therapies were 52-100%, with recurrence in 7-48% of cases and a change in penile sensitivity in 50%. Circumcision cleared preputial PeIN. Rates of recurrence after surgical treatment of glans PeIN were 25% for wide local excision, 4% for Mohs surgery, 5% for total glans resurfacing, and 10% for glansectomy. There are limited data on factors predictive of treatment response and on sequencing of treatment options. PATIENT SUMMARY: Several treatment options are available for men with precancerous lesions of the foreskin or glans. Close follow-up is necessary as lesions can recur or progress to invasive penile cancer.
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Affiliation(s)
- Allaudin Issa
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Kirby Sebro
- Department of Urology, Western General Hospital, Edinburgh, UK
| | - Abigail Kwok
- Department of Urology, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Florian Janisch
- Department of Urology, Medical University of Hamburg, Hamburg, Germany
| | | | - Esther Lee
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Marc Lucky
- Department of Urology, Aintree University Hospital NHS Foundation Trust, Liverpool, UK
| | - Pedro Oliveira
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Maurice Lau
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Arie Parnham
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK
| | - Vijay Sangar
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK; Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - Christian D Fankhauser
- Department of Urology, The Christie NHS Foundation Trust, Manchester, UK; Luzerner Kantonsspital, Luzern, Switzerland.
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