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Vedhanayagam M, Rajagopalan R, Revathi K, Balamurugan BR, Srinivasahan KG, Damodaran D. Chronic extensive warty eruptions on the genital, pubic, crural, and perianal region. Indian J Sex Transm Dis AIDS 2023; 44:193-194. [PMID: 38223153 PMCID: PMC10785097 DOI: 10.4103/ijstd.ijstd_103_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/08/2023] [Accepted: 11/08/2023] [Indexed: 01/16/2024] Open
Affiliation(s)
- Mohankumar Vedhanayagam
- Department of Skin, STDs and Leprosy, Government Erode Medical College Hospital, Erode, Tamil Nadu, India
| | - Rajesh Rajagopalan
- Department of Skin, STDs and Leprosy, Government Erode Medical College Hospital, Erode, Tamil Nadu, India
| | - K. Revathi
- Department of Skin, STDs and Leprosy, Government Erode Medical College Hospital, Erode, Tamil Nadu, India
| | - B. R. Balamurugan
- Department of Skin, STDs and Leprosy, Government Erode Medical College Hospital, Erode, Tamil Nadu, India
| | - K. G. Srinivasahan
- Department of Skin, STDs and Leprosy, Government Erode Medical College Hospital, Erode, Tamil Nadu, India
| | - Devi Damodaran
- Department of Skin, STDs and Leprosy, Government Erode Medical College Hospital, Erode, Tamil Nadu, India
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Scornajenghi CM, Asero V, Bologna E, Basile G, De Angelis M, Moschini M, Del Giudice F. Organ-sparing treatment for T1 and T2 penile cancer: an updated literature review. Curr Opin Urol 2023; Publish Ahead of Print:00042307-990000000-00098. [PMID: 37377374 DOI: 10.1097/mou.0000000000001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
PURPOSE OF REVIEW Penile cancer (PeCa) is an orphan disease due to its rare incidence in high-income countries. Traditional surgical options for clinical T1-2 disease, including partial and total penectomy, can dramatically affect patient's quality of life and mental health status. In selected patients, organ-sparing surgery (OSS) has the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of various OSSs currently available for men diagnosed with PeCa seeking an organ-preserving option. RECENT FINDINGS Patient survival largely depends on spotting and treating lymph node metastasis at an early stage. The required surgical and radiotherapy skill sets cannot be expected to be available in all centers. Consequently, patients should be referred to high-volume centers to receive the best available treatments for PeCa. SUMMARY OSS should be used for small and localized PeCa (T1-T2) as an alternative to partial penectomy to preserve patient's quality of life while maintaining sexual and urinary function and penile aesthetics. Overall, there are different techniques that can be used with different response and recurrence rates. In case of tumor recurrence, partial penectomy or radical penectomy is feasible, without impacting overall survival.
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Affiliation(s)
- Carlo Maria Scornajenghi
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Eugenio Bologna
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Giuseppe Basile
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Mario De Angelis
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Moschini
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
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3
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European Association of Urology-American Society of Clinical Oncology Collaborative Guideline on Penile Cancer: 2023 Update. Eur Urol 2023; 83:548-560. [PMID: 36906413 DOI: 10.1016/j.eururo.2023.02.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023]
Abstract
CONTEXT Penile cancer is a rare disease but has a significant impact on quality of life. Its incidence is increasing, so it is important to include new and relevant evidence in clinical practice guidelines. OBJECTIVE To provide a collaborative guideline that offers worldwide physician and patient guidance for the management of penile cancer. EVIDENCE ACQUISITION Comprehensive literature searches were performed for each section topic. In addition, three systematic reviews were conducted. Levels of evidence were assessed, and a strength rating for each recommendation was assigned according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology. EVIDENCE SYNTHESIS Penile cancer is a rare disease but its global incidence is increasing. Human papillomavirus (HPV) is the main risk factor for penile cancer and pathology should include an assessment of HPV status. The main aim of primary tumour treatment is complete tumour eradication, which has to be balanced against optimal organ preservation without compromising oncological control. Early detection and treatment of lymph node (LN) metastasis is the main determinant of survival. Surgical LN staging with sentinel node biopsy is recommended for patients with a high-risk (≥pT1b) tumour with cN0 status. While (inguinal) LN dissection remains the standard for node-positive disease, multimodal treatment is needed in patients with advanced disease. Owing to a lack of controlled trials and large series, the levels of evidence and grades of recommendation are low in comparison to those for more common diseases. CONCLUSIONS This collaborative penile cancer guideline provides updated information on the diagnosis and treatment of penile cancer for use in clinical practice. Organ-preserving surgery should be offered for treatment of the primary tumour when feasible. Adequate and timely LN management remains a challenge, especially in advanced disease stages. Referral to centres of expertise is recommended. PATIENT SUMMARY Penile cancer is a rare disease that significantly impacts quality of life. While the disease can be cured in most cases without lymph node involvement, management of advanced disease remains challenging. Many unmet needs and unanswered questions remain, underlining the importance of research collaborations and centralisation of penile cancer services.
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4
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Rafael TS, Rotman J, Brouwer OR, van der Poel HG, Mom CH, Kenter GG, de Gruijl TD, Jordanova ES. Immunotherapeutic Approaches for the Treatment of HPV-Associated (Pre-)Cancer of the Cervix, Vulva and Penis. J Clin Med 2022; 11:jcm11041101. [PMID: 35207374 PMCID: PMC8876514 DOI: 10.3390/jcm11041101] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/15/2022] [Accepted: 02/17/2022] [Indexed: 02/07/2023] Open
Abstract
Human papillomavirus (HPV) infection drives tumorigenesis in almost all cervical cancers and a fraction of vulvar and penile cancers. Due to increasing incidence and low vaccination rates, many will still have to face HPV-related morbidity and mortality in the upcoming years. Current treatment options (i.e., surgery and/or chemoradiation) for urogenital (pre-)malignancies can have profound psychosocial and psychosexual effects on patients. Moreover, in the setting of advanced disease, responses to current therapies remain poor and nondurable, highlighting the unmet need for novel therapies that prevent recurrent disease and improve clinical outcome. Immunotherapy can be a useful addition to the current therapeutic strategies in various settings of disease, offering relatively fewer adverse effects and potential improvement in survival. This review discusses immune evasion mechanisms accompanying HPV infection and HPV-related tumorigenesis and summarizes current immunotherapeutic approaches for the treatment of HPV-related (pre-)malignant lesions of the uterine cervix, vulva, and penis.
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Affiliation(s)
- Tynisha S. Rafael
- Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; (T.S.R.); (O.R.B.); (H.G.v.d.P.)
| | - Jossie Rotman
- Department of Obstetrics and Gynecology, Center for Gynecological Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (J.R.); (C.H.M.); (G.G.K.)
| | - Oscar R. Brouwer
- Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; (T.S.R.); (O.R.B.); (H.G.v.d.P.)
| | - Henk G. van der Poel
- Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; (T.S.R.); (O.R.B.); (H.G.v.d.P.)
| | - Constantijne H. Mom
- Department of Obstetrics and Gynecology, Center for Gynecological Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (J.R.); (C.H.M.); (G.G.K.)
| | - Gemma G. Kenter
- Department of Obstetrics and Gynecology, Center for Gynecological Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (J.R.); (C.H.M.); (G.G.K.)
| | - Tanja D. de Gruijl
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands;
| | - Ekaterina S. Jordanova
- Department of Urology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands; (T.S.R.); (O.R.B.); (H.G.v.d.P.)
- Department of Obstetrics and Gynecology, Center for Gynecological Oncology Amsterdam (CGOA), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands; (J.R.); (C.H.M.); (G.G.K.)
- Correspondence:
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5
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Putra IB, Jusuf NK, Theresia C. The Efficacy of Topical Photodynamic Therapy in Precancerous Lesions of the Skin: A Literature Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
Precancerous skin lesions are associated with high probability of malignant transformation to squamous cell carcinoma. Early detection and management are necessary to improve prognosis and outcomes. Literatures showed that topical photodynamic therapy (PDT) is a promising treatment method which can be successfully applied in several conditions in dermatology. This study aims to review the efficacy of topical PDT for various precancerous lesions in dermatology, such as actinic keratosis, Bowen disease, and Bowenoid papulosis.
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6
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Kristiansen S, Torbrand C, Svensson Å, Forslund O, Bjartling C. Incidence and treatment strategies of Penile Intraepithelial Neoplasia in Sweden 2000‐2019. BJU Int 2022; 129:752-759. [PMID: 35044047 PMCID: PMC9303967 DOI: 10.1111/bju.15688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/02/2021] [Accepted: 12/30/2021] [Indexed: 11/30/2022]
Abstract
Objectives Materials and methods Results Conclusions
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Affiliation(s)
- S Kristiansen
- Department of Dermatology and Venereology Skane University Hospital Lund University Malmö Sweden
| | - C Torbrand
- Department of Urology Helsingborg Hospital, Helsingborg, Sweden. Institution of Translational Medicine, Lund University Malmö Sweden
| | - Å Svensson
- Department of Dermatology and Venereology Skane University Hospital Lund University Malmö Sweden
| | - O Forslund
- Laboratory Medicine Department of Medical Microbiology Lund University Lund Sweden
| | - C Bjartling
- Department of Obstetrics and Gynaecology Skane University Hospital Lund University Malmö Sweden
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7
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Nemirovsky DR, Singh R, Jalalian A, Malik RD. Urologic dermatology: a comprehensive foray into the noninfectious etiologies of balanitis. Int J Dermatol 2021; 61:1467-1478. [PMID: 34826136 DOI: 10.1111/ijd.15985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/06/2021] [Accepted: 11/06/2021] [Indexed: 11/26/2022]
Abstract
Balanitis is classically defined as inflammation of the glans penis, often also encompassing the prepuce (balanoposthitis). Several investigations have found that a sizable proportion of urology clinic visits are due to balanitis or related complaints. Balanitis can have numerous complications, including severe pain, urethral stenosis, phimosis, sexual dysfunction, and if untreated, malignancy. Unfortunately, there is no recent or comprehensive review that describes the various etiologies, clinical workup, and treatments for balanitis. Herein this review, we attempt to provide the reader with a complete and updated guide to balanitis in an attempt to improve clinical outcomes.
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Affiliation(s)
- Daniel R Nemirovsky
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
| | - Rohan Singh
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Aria Jalalian
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Rena D Malik
- Division of Urology, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
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8
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Kim TY, Das M, Poppito N, Jarrett P. Immunotherapy for the treatment of penile intraepithelial neoplasia associated with human papilloma virus type 16 using topical imiquimod and human papilloma virus vaccination. Australas J Dermatol 2021; 62:e589-e591. [PMID: 34463960 DOI: 10.1111/ajd.13709] [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: 04/25/2021] [Revised: 07/10/2021] [Accepted: 08/16/2021] [Indexed: 11/26/2022]
Abstract
Penile intraepithelial neoplasia (PeIN) is frequently associated with human papilloma virus (HPV). Three cases of PeIN associated with HPV-type 16 were successfully treated with topical imiquimod and concurrent HPV vaccination. Human papilloma vaccine protects against oncogenic human papilloma viruses. In New Zealand, a decline in incidence of PeIN is anticipated with the recent funding of human papilloma vaccine for boys and young men aged 9-26 years. Therefore, HPV vaccination may have a role for treatment of PeIN and prophylaxis.
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Affiliation(s)
- Tae Yeb Kim
- Departments of, Dermatology, Middlemore Hospital, Auckland, New Zealand
| | - Moushumi Das
- Departments of, Dermatology, Middlemore Hospital, Auckland, New Zealand
| | - Natalie Poppito
- Department of, Histopathology, Middlemore Hospital, Auckland, New Zealand
| | - Paul Jarrett
- Departments of, Dermatology, Middlemore Hospital, Auckland, New Zealand.,Department of Medicine, The University of Auckland, Auckland, New Zealand
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9
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Abstract
PURPOSE OF REVIEW To review the current literature and guidelines regarding salvage therapy for local and regional recurrence of primary penile cancer. RECENT FINDINGS While invasive surgical management has not significantly changed, penile sparing treatments (PSTs) may have a promising role in the management of local recurrence. Penile sparing surgeries do appear to have higher rates of recurrence. However, the overall survival rate is comparable to that of partial and total penectomies. Additionally, a combination of therapies may have a more profound effect on management of penile cancer. SUMMARY Clinicians must discuss the role of each type of therapy for penile cancer with their patients, and tailor their management to the extent of disease in each patient. While it is important to discuss the balance between quality of life and rates of relapse, one must also emphasize the rates of overall survival in patients with local recurrence who are treated with PSTs.
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10
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Thomas A, Necchi A, Muneer A, Tobias-Machado M, Tran ATH, Van Rompuy AS, Spiess PE, Albersen M. Penile cancer. Nat Rev Dis Primers 2021; 7:11. [PMID: 33574340 DOI: 10.1038/s41572-021-00246-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 12/27/2022]
Abstract
Penile squamous cell carcinoma (PSCC) is a rare cancer with orphan disease designation and a prevalence of 0.1-1 per 100,000 men in high-income countries, but it constitutes up to 10% of malignancies in men in some African, Asian and South American regions. Risk factors for PSCC include the absence of childhood circumcision, phimosis, chronic inflammation, poor penile hygiene, smoking, immunosuppression and infection with human papillomavirus (HPV). Several different subtypes of HPV-related and non-HPV-related penile cancers have been described, which also have different prognostic profiles. Localized disease can be effectively managed by topical therapy, surgery or radiotherapy. As PSCC is characterized by early lymphatic spread and imaging is inadequate for the detection of micrometastatic disease, correct and upfront surgical staging of the inguinal lymph nodes is crucial in disease management. Advanced stages of disease require multimodal management. Optimal sequencing of treatments and patient selection are still being investigated. Cisplatin-based chemotherapy regimens are the mainstay of systemic therapy for advanced PSCC, but they have poor and non-durable responses and high rates of toxic effects, indicating a need for the development of more effective and less toxic therapeutic options. Localized and advanced penile cancers and their treatment have profound physical and psychosexual effects on the quality of life of patients and survivors by altering sexual and urinary function and causing lymphoedema.
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Affiliation(s)
- Anita Thomas
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Urology, University Hospitals Leuven, Leuven, Belgium.,Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany
| | - Andrea Necchi
- Genitourinary Medical Oncology, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Asif Muneer
- Department of Urology, University College London Hospitals, London, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals, London, UK.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Marcos Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, Instituto do Cancer Vieira de Carvalho, São Paulo, Brazil
| | - Anna Thi Huyen Tran
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Maarten Albersen
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. .,Department of Urology, University Hospitals Leuven, Leuven, Belgium.
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11
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Abstract
Penile cancer is a rare malignancy with a reported incidence of 0.66–1.44 per 100,000 men, and a reported mortality of 0.15–0.37 per 10,000 men. Expert clinical examination and histological diagnosis from biopsy is required to determine the extent and invasion of disease, which is paramount in planning of appropriate treatment. Management of loco-regional penile cancer can be divided into management of primary tumour and management of regional lymph nodes. This review article will focus on the management of the primary penile tumour with particular focus on penile sparing therapies. The aim of primary penile tumour management is to completely remove the tumour whilst preserving as much organ function as possible. Preservation of the penis is important as it allows patients to maintain urinary and sexual function, as well as quality of life. With the majority of penile cancer confined to the glans and foreskin, most penile cancers can be managed with organ-preserving therapy. A wide variety of treatment options are available, and this review aims to describe each of the options including the reported oncological and functional outcome for the different therapies for penile cancer.
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Affiliation(s)
- Henry Han-I Yao
- Department of Urology, Eastern Health, Melbourne, Australia.,Department of Urology, Western Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Shomik Sengupta
- Department of Urology, Eastern Health, Melbourne, Australia.,Eastern Health Clinical School, Monash University, Melbourne, Australia
| | - Justin Chee
- Department of Urology, Western Health, Melbourne, Australia.,Department of Urology, Alfred Health, Melbourne, Australia
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12
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Abstract
Penile cancers are rare malignancies. Traditional surgical options, including partial and total penectomy, can dramatically affect a patient's quality of life and mental health. In select patients, penile sparing techniques (PST) have the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual function, and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of the various PST currently available for men seeking an organ-preserving option for their penile cancer.
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Affiliation(s)
- Andrew Fang
- The University of Alabama, Birmingham School of Medicine- Urology , Birmingham, AL, USA
| | - James Ferguson
- The University of Alabama, Birmingham School of Medicine- Urology , Birmingham, AL, USA.,The University of Alabama, Birmingham School of Medicine- O'Neal Comprehensive Cancer Center , Birmingham, AL, USA
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13
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Penile cancer: potential target for immunotherapy? World J Urol 2020; 39:1405-1411. [PMID: 33145666 DOI: 10.1007/s00345-020-03510-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/23/2020] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Penile cancer (PeCa) is a rare malignancy with a poor prognosis in advanced disease. There is still a limited understanding of the biological mediators that are important in the prognosis and therapy of the disease. This review aims to provide a summary of the immune micro-environment, molecular oncogenesis and the role of HPV in the disease applying to the potential of the use of immunotherapy. METHODS Narrative, non-systematic review based on publications retrieved by PubMed and EMBASE search. RESULTS The molecular mechanisms underlying penile carcinogenesis are complex, and human papillomavirus (HPV) infection is a well-characterized driver of penile cancer. Up to 50% of the penile carcinomas are HPV related. There is potential to improve prevention, treatment and follow-up strategies pertaining to the role of HPV in penile cancer. Immune response modifiers such as toll-like receptor agonists are being used in a topical fashion for penile intraepithelial neoplasia while immune checkpoint inhibitors are currently under clinical investigation for its application in penile cancer. CONCLUSIONS The knowledge of prognosis-relevant biological pathways in penile cancer is expanding. HPV plays an important role in the carcinogenesis. This can lead to the identification of therapeutic targets which could significantly influence the prognosis of advanced penile cancer. Clinical trials are being conducted to pave the way for immune-modifying treatment modalities.
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14
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Topical chemotherapy for penile carcinoma in situ: Contemporary outcomes and reported toxicity. Urol Oncol 2020; 39:72.e1-72.e5. [PMID: 33036902 DOI: 10.1016/j.urolonc.2020.09.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 08/16/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
Abstract
PURPOSE The toxicity of topical chemotherapeutics has been well-characterized in extra-genital squamous cell carcinoma; however, there is limited data regarding the use of topical agents for penile squamous cell carcinoma in situ (CIS). We aim to describe the clinical outcomes and toxicities associated with the use of topical fluorouracil and imiquimod for penile CIS. MATERIALS AND METHODS We performed an observational analysis of penile CIS cases treated with topical chemotherapy from 2009 to 2019 at a tertiary cancer center. RESULTS Twenty patients with penile CIS received fluorouracil (n= 17, 85%) or imiquimod (n = 3, 15%). The median age was 66 years. The median follow-up was 18 months. Complete response (CR) was achieved in 65% (n= 13/20), partial response in 25% (n = 5/20), and no response in 10% (n = 2/20). Overall, 50% required additional alternative treatments due to lack of CR or relapse. The median recurrence-free survival was 14 months. Fifty percent of patients reported Common Terminology Criteria for Adverse Events v5.0 grade 1 to 2 acute toxicities, including local skin irritation (40%), pain (35%), dysuria (5%), or nausea (5%). Only 65% completed the full course of treatment. Nonadherence was associated with a diminished CR rate of 28.6%. CONCLUSIONS Topical chemotherapy is a reasonable first-line therapy for penile CIS. A substantial proportion of patients experience acute toxicity and are unable to complete the full course of therapy. We recommend that patients with penile CIS be monitored regularly in order to promptly address issues with adherence and toxicity associated with topical treatment.
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15
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Kravvas G, Ge L, Ng J, Shim TN, Doiron PR, Watchorn R, Kentley J, Panou E, Dinneen M, Freeman A, Jameson C, Haider A, Francis N, Minhas S, Alnajjar H, Muneer A, Bunker CB. The management of penile intraepithelial neoplasia (PeIN): clinical and histological features and treatment of 345 patients and a review of the literature. J DERMATOL TREAT 2020; 33:1047-1062. [DOI: 10.1080/09546634.2020.1800574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- G. Kravvas
- Department of Dermatology, University College London Hospitals, London, UK
| | - L. Ge
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Ng
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - T. N. Shim
- Department of Dermatology, University College London Hospitals, London, UK
| | - P. R. Doiron
- Department of Dermatology, University College London Hospitals, London, UK
| | - R. Watchorn
- Department of Dermatology, University College London Hospitals, London, UK
| | - J. Kentley
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
| | - E. Panou
- Department of Dermatology, University College London Hospitals, London, UK
| | - M. Dinneen
- Department of Urology, Chelsea & Westminster Hospital, London, UK
| | - A. Freeman
- Department of Histopathology, University College London Hospitals, London, UK
| | - C. Jameson
- Department of Histopathology, University College London Hospitals, London, UK
| | - A. Haider
- Department of Histopathology, University College London Hospitals, London, UK
| | - N. Francis
- Department of Histopathology, Imperial College Hospitals, London, UK
| | - S. Minhas
- Department of Urology, Imperial College Hospitals, London, UK
| | - H. Alnajjar
- Department of Urology, University College London Hospitals, London, UK
| | - A. Muneer
- Department of Urology, University College London Hospitals, London, UK
| | - C. B. Bunker
- Department of Dermatology, University College London Hospitals, London, UK
- Department of Dermatology, Chelsea & Westminster Hospital, London, UK
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16
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Successes of photodynamic therapy in treatment of erythroplasia of Queyrat. BIOMEDICAL PHOTONICS 2020. [DOI: 10.24931/2413-9432-2020-9-1-34-41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Luo Z, Chen M, Su J, Chen X, Zhao S. A case of bowenoid papulosis treated with sequential curettage and photodynamic therapy. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2020; 36:251-253. [PMID: 32052495 DOI: 10.1111/phpp.12540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/03/2020] [Accepted: 02/08/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Zhongling Luo
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Shuang Zhao
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
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18
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Clinical Management of Anogenital Warts and Intraepithelial Neoplasia. Sex Transm Infect 2020. [DOI: 10.1007/978-3-030-02200-6_12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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19
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Takla A, Wiese-Posselt M, Harder T, Meerpohl JJ, Röbl-Mathieu M, Terhardt M, van der Sande M, Wichmann O, Zepp F, Klug SJ. Background paper for the recommendation of HPV vaccination for boys in Germany. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 61:1170-1186. [PMID: 30167729 DOI: 10.1007/s00103-018-2791-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Anja Takla
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | | | - Thomas Harder
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Jörg J Meerpohl
- Institute for Evidence in Medicine (for Cochrane Germany Foundation), Medical Center, University of Freiburg, Freiburg, Germany
| | | | | | | | - Ole Wichmann
- Immunization Unit, Robert Koch Institute, Berlin, Germany
| | - Fred Zepp
- Center for Pediatric and Adolescent Medicine, University Medical Center Mainz, Mainz, Germany
| | - Stefanie J Klug
- Department of Epidemiology, Faculty of Sport and Health Sciences, Technical University Munich, Bielefeld, Germany
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20
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Joly E, Lefranc H, Comoz F, Lefort F, Pédaillès S, Chevallier JM, Dompmartin A. [Carbon dioxide laser treatment of genital intraepithelial neoplasia: A retrospective study]. Ann Dermatol Venereol 2019; 146:542-549. [PMID: 31320185 DOI: 10.1016/j.annder.2019.03.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 11/14/2018] [Accepted: 03/06/2019] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Genital intraepithelial neoplasias (IEN) are precursors of squamous cell carcinoma. The ideal treatment must be efficacious, conservative and well-tolerated. CO2 laser is one of the recommended therapies, but its efficacy and safety have not been extensively studied. PATIENTS AND METHODS This was a retrospective single-center study. Sixteen patients (8 women and 8 men) treated with CO2 laser for genital IEN, whether high-grade or differentiated, were included. Surgical lateral margins of 3 to 5mm were taken macroscopically during treatment. The CO2 laser session, assessment of therapeutic response and follow-up were undertaken by a dermatologist at the University Hospital of Caen. RESULTS The mean patient age was 68.1 years and mean follow-up was 52.7 months (5-130). Lesions were isolated in 87.5% of patients. The recurrence rates of genital intraepithelial neoplasia after CO2 laser treatment were 58% for women and 40% for men. No impact on quality of life or on sexual activity was reported in over 90% of patients. CONCLUSION Whatever the treatment recommended for intraepithelial neoplasia, recurrence is frequent. CO2 laser is an effective and well-tolerated conservative therapeutic option. It enables rapid clinical remission, but as with all currently available treatments, long-term dermatologic follow-up remains necessary.
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Affiliation(s)
- E Joly
- Service de dermatologie, CHU de Caen, avenue de la côte de Nacre, 14033 Caen, France; Faculté de médecine, université de Caen Basse-Normandie, Caen, France.
| | - H Lefranc
- Service de dermatologie, CHU de Caen, avenue de la côte de Nacre, 14033 Caen, France; Faculté de médecine, université de Caen Basse-Normandie, Caen, France
| | - F Comoz
- Service d'anatomopathologie, CHU de Caen, 14033 Caen, France
| | - F Lefort
- Service du DIM, CHU de Caen, 14033 Caen, France
| | - S Pédaillès
- Service de dermatologie, CHIC Alençon-Mamers, 61000 Alençon, France
| | - J-M Chevallier
- Service de dermatologie, CHU de Caen, avenue de la côte de Nacre, 14033 Caen, France
| | - A Dompmartin
- Service de dermatologie, CHU de Caen, avenue de la côte de Nacre, 14033 Caen, France; Faculté de médecine, université de Caen Basse-Normandie, Caen, France
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21
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Caposiena Caro RD, Di Prete M, Didona D, Sechi A, Orlandi A, Bianchi L. Treatment of recalcitrant squamous carcinoma in situ of penis with tapering imiquimod 5-3.75% cream. Dermatol Ther 2019; 32:e12904. [PMID: 30964593 DOI: 10.1111/dth.12904] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/05/2019] [Indexed: 11/30/2022]
Affiliation(s)
| | - Monia Di Prete
- Department of Pathological Anatomy, University of Rome Tor Vergata, Rome, Italy
| | - Dario Didona
- Department of Dermatology and Allergology, University of Marburg, Marburg, Germany
| | - Andrea Sechi
- Division of Dermatology, Department of Experimental, Diagnostic and Speciality Medicine, University of Bologna, Bologna, Italy
| | - Augusto Orlandi
- Department of Pathological Anatomy, University of Rome Tor Vergata, Rome, Italy
| | - Luca Bianchi
- Dermatology Department, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
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22
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Yokoyama M, Egawa G, Makino T, Egawa K. Erythroplasia of Queyrat treated with imiquimod 5% cream: The necessity of regimen guidelines. Clin Case Rep 2019; 7:723-725. [PMID: 30997072 PMCID: PMC6452465 DOI: 10.1002/ccr3.2076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/30/2019] [Accepted: 02/01/2019] [Indexed: 11/08/2022] Open
Abstract
Development of noninvasive treatments for erythroplasia of Queyrat, a carcinoma in situ, is expected. This case suggests topical imiquimod might be a candidate with regimens consisting of much longer duration of the treatment than for genital warts and the maintenance phase of the treatment course to prevent the relapse.
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Affiliation(s)
| | - Gyohei Egawa
- Department of Dermatology, Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Takamitsu Makino
- Department of Dermatology and Plastic Surgery, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
| | - Kiyofumi Egawa
- Division of Dermatology, Amakusa Dermatology and Internal Medicine ClinicKamiamakusaJapan
- Department of DermatologyKumamoto University HospitalKumamotoJapan
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23
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Organ-sparing surgical and nonsurgical modalities in primary penile cancer treatment. Curr Opin Urol 2019; 29:156-164. [DOI: 10.1097/mou.0000000000000587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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24
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Dauendorffer JN, Renaud-Vilmer C, Cavelier Balloy B, Meria P, Desgrandchamps F, Bagot M. [Penile intra-epithelial neoplasia]. Prog Urol 2018; 28:466-474. [PMID: 29937064 DOI: 10.1016/j.purol.2018.05.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/20/2018] [Accepted: 05/18/2018] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Penile intra-epithelial neoplasia (PIN) are precancerous lesions, characterized by architectural and cytological abnormalities of the genital epithelium, from which can arise squamous carcinomas. METHODS A literature review was performed on the Medline database, considering the articles listed between October 2007 and October 2017 dealing with PIN, using the following keywords "intraepithelial neoplasia" or "Bowen's disease" or "erythroplasia of Queyrat" or "bowenoid papulosis" and "penis ». Papers were selected according to their language (English and French) and their relevance. RESULTS One hundred seventy four articles related to PIN were listed. Twenty-five of them were selected for their relevance. The analysis of the references of these articles identified 6 relevant papers published before October 2007, which were considered for this review based on a total of thirty-one articles. We describe clinical and pathological characteristics of PIN, emphasizing treatment modalities. CONCLUSION Urologists should distinguish HPV-related and non HPV-related PIN, both of them sharing clinical presentation, but needing different management.
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Affiliation(s)
- J N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - C Renaud-Vilmer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - B Cavelier Balloy
- Service d'anatomopathologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - P Meria
- Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - F Desgrandchamps
- Service d'urologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Bagot
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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25
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26
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Shaw KS, Nguyen GH, Lacouture M, Deng L. Combination of imiquimod with cryotherapy in the treatment of penile intraepithelial neoplasia. JAAD Case Rep 2017; 3:546-549. [PMID: 29264388 PMCID: PMC5728708 DOI: 10.1016/j.jdcr.2017.07.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Katharina S. Shaw
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Giang H. Nguyen
- Department of Dermatology, Anschultz Medical Campus, University of Colorado, New York, New York
| | - Mario Lacouture
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Liang Deng
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
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27
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Kamel MH, Bissada N, Warford R, Farias J, Davis R. Organ Sparing Surgery for Penile Cancer: A Systematic Review. J Urol 2017; 198:770-779. [DOI: 10.1016/j.juro.2017.01.088] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2017] [Indexed: 01/01/2023]
Affiliation(s)
- Mohamed H. Kamel
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB)
| | - Nabil Bissada
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB)
| | - Renee Warford
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB)
| | - Judy Farias
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB)
| | - Rodney Davis
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
- Department of Urology, Baylor School of Medicine and Michael E. Debakey VA Medical Center, Houston, Texas (NB)
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28
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Manjunath A, Brenton T, Wylie S, Corbishley CM, Watkin NA. Topical Therapy for non-invasive penile cancer (Tis)-updated results and toxicity. Transl Androl Urol 2017; 6:803-808. [PMID: 29184776 PMCID: PMC5673801 DOI: 10.21037/tau.2017.06.24] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/15/2017] [Indexed: 12/21/2022] Open
Abstract
Penile cancer is a rare malignancy estimated to affect 26,000 men globally each year. The association with penile cancer, in particular non-invasive disease, and human papilloma virus (HPV) is well known. Ninety-five percent of cases of penile cancer are squamous cell carcinoma (SCC), which are staged using the TNM staging system. Terminology describing the histological appearance of non-invasive penile cancer has changed with all cases grouped under the umbrella term of penile intraepithelial neoplasia (PeIN); either undifferentiated or differentiated. This replaces previous terms such as carcinoma in situ (CIS) and eponymous names such as Bowen's disease. This change is recognised by the World Health Organisation (WHO). The topical treatments most commonly used for PeIN are 5-fluorouracil (5-FU) and imiquimod (IQ). Other treatments such as photodynamic therapy (PDT) are used but to a lesser degree. The evidence for all of these treatments is heterogenous with no randomised data available. Overall up to 57% complete response has been reported with a low number of serious adverse events. In this article, we aim to review the available evidence for the topical treatment of non-invasive penile cancer specifically regarding its efficacy and toxicity.
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Affiliation(s)
| | | | - Sarah Wylie
- Department of Urology, St George’s Hospital, London, UK
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29
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Dauendorffer JN, Cavelier Balloy B, Bagot M, Renaud-Vilmer C. [HPV-induced penile intra-epithelial neoplasia: Bowenoid papulosis]. Ann Dermatol Venereol 2017; 144:220-224. [PMID: 28117082 DOI: 10.1016/j.annder.2016.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/27/2016] [Accepted: 12/09/2016] [Indexed: 10/20/2022]
Affiliation(s)
- J-N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - B Cavelier Balloy
- Service d'anatomopathologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Bagot
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - C Renaud-Vilmer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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