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Lenart S, Koperek O, Scharrer A, Comperat E. "Bone in the penis" or fasciitis ossificans of the penis - a first time description of a pseudo-tumor at an extraordinary site. BMC Urol 2024; 24:83. [PMID: 38594664 PMCID: PMC11005136 DOI: 10.1186/s12894-024-01475-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 04/03/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Fasciitis ossificans is a rare subtype of nodular fasciitis, a benign soft tissue tumor with reactive characteristics. Due to its rapid growth, it is often misdiagnosed as a malignant tumor. While fasciitis ossificans commonly originates from the subcutaneous tissue and can appear throughout the body, it may also arise from extraordinary sites. CASE PRESENTATION We report the first-ever documented case of fasciitis ossificans arising from the penis in a male patient who presented with a tumor on the glans penis. The tumor was surgically resected due to suspicion of penile cancer. Initial histopathological analysis led to a misdiagnosis of squamous cell carcinoma. However, pathological consultation ultimately confirmed the diagnosis of fasciitis ossificans of the penis originating from the glans penis by demonstrating ossification. CONCLUSION This case underscores the importance of considering fasciitis ossificans in the differential diagnosis of soft tissue tumors, even in unusual locations such as penile soft tissue.
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Affiliation(s)
- Sebastian Lenart
- Department of Urology and Andrology, St. John of God Hospital, Vienna, Austria.
- Department of Urology, Paracelsus Medical University Salzburg, Salzburg, Austria.
| | - Oskar Koperek
- Laboratories for pathology Kaserer, Koperek and Beer, Vienna, Austria
| | - Anke Scharrer
- Department of Pathology, Medical University Vienna, Vienna, Austria
| | - Eva Comperat
- Department of Pathology, Medical University Vienna, Vienna, Austria
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2
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Dräger DL, Nolting J, Pohla M, Hakenberg OW. [Lymph node metastatic penile cancer: a challenge in uro-oncology-guideline-conform treatment]. Urologie 2024; 63:367-372. [PMID: 38270604 DOI: 10.1007/s00120-023-02266-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/26/2024]
Abstract
Penile squamous cell carcinoma is a rare, highly aggressive cancer of older men. The metastatic stage has significant therapeutic and prognostic features. Treatment of penile cancer is significantly influenced by the operation, in which an R0 situation must be achieved to ensure a realistic chance of cure. Other local therapeutic procedures such as radiotherapy are often of secondary importance. Neoadjuvant and adjuvant chemotherapy are relevant components of multimodal therapy. Post-therapeutically, patients require lifelong, risk-adapted follow-up care.
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Affiliation(s)
- D L Dräger
- Urologische Klinik, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.
| | - J Nolting
- Urologische Klinik, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland
| | - M Pohla
- Urologische Klinik, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland
| | - O W Hakenberg
- Urologische Klinik, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland
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3
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Luo J, Hu J, Mulati Y, Wu Z, Lai C, Kong D, Liu C, Xu K. Developing and validating a nomogram for penile cancer survival: A comprehensive study based on SEER and Chinese data. Cancer Med 2024; 13:e7111. [PMID: 38566587 PMCID: PMC10988236 DOI: 10.1002/cam4.7111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE The primary aim of this study was to create a nomogram for predicting survival outcomes in penile cancer patients, utilizing data from the Surveillance, Epidemiology, and End Results (SEER) and a Chinese organization. METHODS Our study involved a cohort of 5744 patients diagnosed with penile cancer from the SEER database, spanning from 2004 to 2019. In addition, 103 patients with penile cancer from Sun Yat-sen Memorial Hospital of Sun Yat-sen University were included during the same period. Based on the results of regression analysis, a nomogram is constructed and validated internally and externally. The predictive performance of the model was evaluated by concordance index (c-index), area under the curve, decision curve analysis, and calibration curve, in internal and external datasets. Finally, the prediction efficiency is compared with the TNM staging model. RESULTS A total of 3154 penile patients were randomly divided into the training group and the internal validation group at a ratio of 2:1. Nine independent risk factors were identified, including age, race, marital status, tumor grade, histology, TNM stage, and the surgical approach. Based on these factors, a nomogram was constructed to predict OS. The nomogram demonstrated relatively better consistency, predictive accuracy, and clinical relevance, with a c-index over 0.73 (in the training cohort, the validation cohort, and externally validation cohort.) These evaluation indexes are far better than the TNM staging system. CONCLUSION Penile cancer, often overlooked in research, has lacked detailed investigative focus and guidelines. This study stands as the first to validate penile cancer prognosis using extensive data from the SEER database, supplemented by data from our own institution. Our findings equip surgeons with an essential tool to predict the prognosis of penile cancer better suited than TNM, thereby enhancing clinical decision-making processes.
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Affiliation(s)
- Jiawen Luo
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Jintao Hu
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Yelisudan Mulati
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Zhikai Wu
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Cong Lai
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Degeng Kong
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Cheng Liu
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Clinical Research Center for Urological DiseasesGuangdongChina
| | - Kewei Xu
- Department of Urology, Sun Yat‐sen Memorial HospitalSun Yat‐sen UniversityGuangzhouChina
- Guangdong Provincial Clinical Research Center for Urological DiseasesGuangdongChina
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Fawzi MM, El Anany G, Abdelraouf MM, Elbendary A. Diagnostically Challenging Multifocal Penile Epithelioid Hemangioma Successfully Treated With Doxorubicin Hydrochloride. Am J Dermatopathol 2024; 46:228-231. [PMID: 38457672 DOI: 10.1097/dad.0000000000002642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
ABSTRACT Epithelioid hemangioma (EH), also known as angiolymphoid hyperplasia with eosinophilia, is an unusual vascular proliferation that tends to manifest in the head and neck region. Its occurrence on the penis is rare, with only scarce reported cases in the literature. The histopathological examination of this condition poses a challenge because it shares similarities with other entities, such as epithelioid hemangioendothelioma, epithelioid angiosarcoma, cutaneous epithelioid angiomatous nodule, or Kaposi sarcoma (KS). The infrequency of EH in penile locations underscores the need for accurate diagnostic differentiation and tailored treatment strategies for this atypical presentation. This case report highlights a rare instance of multifocal penile EH. The patient's lesions exhibited distinctive histopathologic features, with extensive eosinophilic infiltration, presence of necrosis, and infiltration to subcutaneous fat. The patient was treated with doxorubicin, a chemotherapy drug, with a very good response. This successful therapeutic outcome underscores the potential efficacy of doxorubicin in the management of multifocal penile EH. The comprehensive analysis of this case contributes to our understanding of the clinical presentation, histopathologic features, and treatment modalities for this rare penile tumor, providing valuable insights for future clinical considerations.
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Affiliation(s)
- Marwa M Fawzi
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and
| | - Galal El Anany
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and
| | | | - Amira Elbendary
- Dermatology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; and
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Colecchia M, Pini GM, Pruneri G, Nicolai N, Servillo S. Soft tissue tumours of the penis. The 30-year Istituto Nazionale Tumori di Milano experience. Pathologica 2024; 116:46-54. [PMID: 38482674 PMCID: PMC10938274 DOI: 10.32074/1591-951x-953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 11/27/2023] [Indexed: 03/17/2024] Open
Abstract
Objective Small series and individual cases of penile soft tissue tumours are reported in the literature: these are rare tumours that represent less than 5% of all penile tumours. Methods Penile soft tissue tumours were collected from the archive of the Department of Pathology at the Istituto Nazionale dei Tumori of Milan between January 1990 and October 2021. All available medical records were retrieved and reviewed to obtain clinical information. Results Our series refers to the 30-year experience of highlighting the heterogeneity in the presentation and microscopic features of these rare sarcomas. 18 penile soft tissue tumours are described, 4 benign and 14 malignant. The mean age at diagnosis was 58.2 years (range 24-96 years) and 53.6 years among malignancies (range 24-89). The most frequent histotype was Kaposi's sarcoma (nr = 4) and very unusual histotypes were observed, namely low-grade fibromyxoid sarcoma, synovial sarcoma, proximal type epithelioid sarcoma and the first reported case of dedifferentiated liposarcoma of the penis. Conclusions Among sarcomas of the genitourinary tract, tumours of the soft tissues of the penis are the rarest. Penile sarcomas can present at a young age. Kaposi's sarcoma in HIV-negative patients has a favorable outcome, while deep sarcomas have an aggressive behavior and poor prognosis.
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Affiliation(s)
- Maurizio Colecchia
- IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Maria Pini
- Department of Pathology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giancarlo Pruneri
- Department of Pathology and Laboratory Medicine, Foundation IRCCS National Cancer Institute, Milan, Italy
- Department of Oncology and Hematoncology, University of Milan, Milan, Italy
| | - Nicola Nicolai
- Urology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Sascia Servillo
- Pathology Unit, Azienda Ospedaliera di Bergamo, Bergamo, Italy
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Zou Y, Tan X, Yuan G, Tang Y, Wang Y, Yang C, Luo S, Wu Z, Yao K. SPP1 is associated with adverse prognosis and predicts immunotherapy efficacy in penile cancer. Hum Genomics 2023; 17:116. [PMID: 38111044 PMCID: PMC10729401 DOI: 10.1186/s40246-023-00558-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The effect of SPP1 in squamous cell carcinoma of the penis (PSCC) remained unknown. We attempted to clarify the function of the SPP1 gene in PSCC. METHOD Eight paired penile cancer specimens (including penile cancer tissue, paracancerous tissue, and positive lymph node tissue) subjected to whole transcriptome sequencing were analysed to identify differentially expressed genes. We used immunohistochemistry to detect the expression of SPP1 protein and immune cell related proteins in penile cancer tissue. Then, we performed weighted gene coexpression network analysis (WGCNA) to identify the genes related to SPP1 in penile cancer tissue and positive lymph node tissue. Based on the GSE57955 dataset, the CIBERSORT and ssGSEA algorithms were carried out to investigate the immune environment of PSCC. GSVA analysis was conducted to identify the signaling pathways related to SPP1 subgroups. Enzyme-linked immunosorbent assay (ELISA) method was adopted to detect SPP1 level in the serum of 60 patients with penile cancer. RESULTS Differential analysis indicated that SPP1 was the most differentially upregulated gene in both penile cancer tissues and positive lymph node tissues. Survival analysis suggested that the prognosis of the low-SPP1 group was significantly poorer than that of the high-SPP1 group. Subsequently, immune-related bioinformatics showed that SPP1 was significantly associated with B cells, CD8 + T cells, CD4 + T cells, macrophages, helper T cells, neutrophils and dendritic cells. The immunohistochemical results showed that the high-SPP1 group was characterized by relatively high expression of CD16 and relatively low expression of CD4. GSVA analysis indicated that high-SPP1 group was significantly associated with immune-related pathways such as PD-L1 expression and the PD-1 checkpoint pathway in cancer and the TNF signaling pathway. ELISA demonstrated that the serum level of SPP1 in patients with positive lymph node metastasis of penile cancer was significantly higher than that in patients with negative lymph node metastasis of penile cancer. CONCLUSION Our study shows that the SPP1 gene might be an effective biomarker for predicting the prognosis and the efficacy of immunotherapy in PSCC patients.
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Affiliation(s)
- Yuantao Zou
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Xingliang Tan
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Gangjun Yuan
- Department of Urology Oncological Surgery, Chongqing University Cancer Hospital, Chongqing, 400030, China
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Yi Tang
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Yanjun Wang
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Cong Yang
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Sihao Luo
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Zhiming Wu
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China.
| | - Kai Yao
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China.
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Sharma A, Velmurugan D, Narayanasamy K. Primary penile tuberculosis masquerading as penile cancer: a case report. Hong Kong Med J 2023; 29:554-555. [PMID: 37914671 DOI: 10.12809/hkmj2210280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023] Open
Affiliation(s)
- A Sharma
- Department of Urology, Kovai Medical Center and Hospital, Coimbatore, India
| | - D Velmurugan
- Department of Urology, Kovai Medical Center and Hospital, Coimbatore, India
| | - K Narayanasamy
- Department of Urology, Kovai Medical Center and Hospital, Coimbatore, India
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Franceschelli A, Palmisano F, Gentile G, Vagnoni V, Zannetti G, Cipriani R, Colombo F. Melanoma of glans penis and urethra: A case report and systematic review of the literature of a rare and complex neoplasm. Urologia 2023; 90:766-774. [PMID: 34528492 DOI: 10.1177/03915603211046471] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To evaluate the features and prognosis of melanoma of glans penis and urethra, with the presentation of a significant case report. MATERIALS AND METHODS A systematic literature review was performed using the MEDLINE (PubMed) and Cochrane Libraries databases to identify all cases of male mucosal melanoma reported. RESULTS Two hundred fifty-two patients with male mucosal primary melanoma were found. Glans penis and fossa navicularis as primary site includes the 81.6% of all lesions considered. Median Breslow's depth is 2.1 mm, whereas nine in situ melanomas have been reported. At the diagnosis, the disease was at a non-localized stage in 21.4% for glans penis melanomas and 11.7% urethral lesions, respectively. The 2 and 5-year survival for glans melanoma is 62.5% and 38.4%; higher rates were observed in the 2012-2020 period (76% and 58.8%, respectively). Two-year survival for urethral melanomas is 66.7%, while 5-year survival is 12.5%. 22 patients survived over 5 years with a Breslow's depth reported always < 3.3 mm. CONCLUSION Melanoma of the glans penis and urethra is a rare neoplasm associated with a poor prognosis, however recent reports show higher survival rates. Surgery remains the mainstay for a localized disease. Taking into account the small number of cases reported, topical imiquimod seems to be a valid non-surgical alterative for melanoma in situ. The use of immunotherapy and targeted therapy should be considered only in an adjuvant setting according to the recommendations of cutaneous melanoma; however, additional clinical data on male mucosal melanoma are needed to draw definitive conclusions.
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Affiliation(s)
| | - Franco Palmisano
- Department of Urology, ASST Fatebenefretalli-Sacco, Luigi Sacco University Hospital, Milan, Italy
| | - Giorgio Gentile
- Andrology Unit, St. Orsola University Hospital, Bologna, Italy
| | - Valerio Vagnoni
- Andrology Unit, St. Orsola University Hospital, Bologna, Italy
| | - Guido Zannetti
- Department of Plastic and Reconstructive Surgery, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Riccardo Cipriani
- Department of Plastic and Reconstructive Surgery, St. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Fulvio Colombo
- Andrology Unit, St. Orsola University Hospital, Bologna, Italy
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Pósfai B, Szentkereszty M, Sánta F, Bajory Z, Simon A, Kozéki Z, Csányi I, Akgul M, Kuthi L. Penile melanoma: a pathological report of two cases. Diagn Pathol 2023; 18:117. [PMID: 37898793 PMCID: PMC10613369 DOI: 10.1186/s13000-023-01404-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/20/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Penile melanoma (PM) is a rare tumor, accounting for less than 2% of all penile cancers. PM can occur on the surface of the glans, foreskin, and opening of the urethra. Furthermore, PM primarily affects older individuals and is not associated with sun exposure. Currently, there is no specific staging system for genitourinary tract melanomas, so these tumors are typically staged using the criteria for cutaneous melanoma. Limited data in the literature suggests that PM generally has a poor clinical prognosis. CASE PRESENTATION Here, we describe two cases of PM. The first case affected a 62-year-old male who presented with hematuria and a painful tumor in the distal urethra, leading to a suspicion of penile cancer. The second case involved a 68-year-old male who noticed a rapidly evolving dark spot on his foreskin. Histological analysis confirmed the presence of melanoma in both patients. The tumors showed a diffuse and strong PRAME-positivity and lacked BRAF mutation in both cases. Additionally, the second tumor harbored an activating CKIT mutation. An enhanced PD-L1 expression was observed in both tumors. CONCLUSIONS We presented two rare forms of mucosal melanoma and highlighted the entities in the differential diagnosis. Based on our experience PRAME is a helpful marker for making the diagnosis of PM, and PD-L1 can predict the success of the immunotherapy. We also emphasize the need for an organ-specific staging system for PMs.
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Affiliation(s)
- Boglárka Pósfai
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1., Szeged, H-6725, Hungary
| | | | - Fanni Sánta
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1., Szeged, H-6725, Hungary
| | - Zoltán Bajory
- Department of Urology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Andrea Simon
- Tumor Pathology Center, National Institute of Oncology, Budapest, Hungary
| | - Zsófia Kozéki
- Department of Dermatology, National Institute of Oncology, Budapest, Hungary
| | - Ildikó Csányi
- Department of Dermatology and Allergology, Albert Szent-Györgyi Medical School, University of Szeged, Szeged, Hungary
| | - Mahmut Akgul
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Levente Kuthi
- Department of Pathology, Albert Szent-Györgyi Medical School, University of Szeged, Állomás utca 1., Szeged, H-6725, Hungary.
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10
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Yu T, Cui X, Liang N, Wu S, Lin C. Postoperative Metachronous Metastasis of Bladder Cancer to Penis: A Case Report. ARCH ESP UROL 2023; 76:622-626. [PMID: 37960961 DOI: 10.56434/j.arch.esp.urol.20237608.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
BACKGROUND Penile metastases are extremely rare events, originating primarily from primary pelvic tumours of the prostate, bladder, and gastrointestinal tract. The underlying mechanism of bladder cancer metastasis to the penis remains unclear. Metastasis to the penis is usually considered a late manifestation of systemic spread. Therefore, the prognosis of patients with penile metastasis remains poor and their survival period is short. Therefore, reporting this rare case will help to better understand the characteristics, diagnosis, and treatment processes of the disease, with the aim of improving the accuracy and efficiency of diagnosis and treatment. CASE DESCRIPTION A 65-year-old male received transurethral resection of a bladder tumor. One year later, he underwent radical cystectomy because of the recurrence and progression of bladder cancer. Postoperative pathology demonstrated that the stage of bladder cancer was T3N0M0. One year later, he discovered a penile mass that gradually grew and became hard, accompanied by urinary retention, but without other clinical symptoms. The patient underwent a complete penectomy. Histopathology and immunohistochemistry results demonstrated the tumour's origin as a bladder urothelial carcinoma. The patient received systemic chemotherapy after surgery, but died 7 months later. CONCLUSIONS Although penile metastasis of bladder cancer typically indicates an advanced stage of the malignant tumour and poor prognosis, we recommend that male patients with a history of bladder cancer should undergo a regular clinical examination of the penis to rapidly detect the disease and receive early treatment. In this case, despite treatment measures such as systemic chemotherapy and penectomy, the patient's prognosis remained poor.
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Affiliation(s)
- Tianxi Yu
- School of Clinical Medicine, Weifang Medical University, 261053 Weifang, Shandong, China
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
| | - Xin Cui
- School of Clinical Medicine, Weifang Medical University, 261053 Weifang, Shandong, China
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
| | - Ning Liang
- School of Clinical Medicine, Weifang Medical University, 261053 Weifang, Shandong, China
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
| | - Shuang Wu
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
| | - Chunhua Lin
- Department of Urology, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, 264000 Yantai, Shandong, China
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O'Brien JS, McVey A, Kelly BD, Chee J, Lawrentschuk N. Recent developments in the diagnosis and management of N1 penile cancer. Curr Opin Urol 2023; 33:64-69. [PMID: 36444651 DOI: 10.1097/mou.0000000000001058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW This article presents a critical review of the current literature to provide a brief update on the contemporary advances in diagnosing and managing N1 penile cancer. RECENT FINDINGS Penile squamous cell carcinoma (pSCC) has evolved from being an orphan field for cancer innovation. Advances in the understanding tumour biology have enabled sophisticated diagnostics and predictive modelling to better characterize inguinal disease. Minimally invasive inguinal lymph node dissection is emerging as a technique that reduces morbidity while maintaining oncological safety. Furthermore, robust clinical trials are underway ,which will provide level one evidence to guide treatment decisions. Exciting advances in the field of immune-oncology offer promise as adjuvant therapies. International collaboration and centralisation of care will be essential to driving translational research and equitable evidence-based care. SUMMARY Improving outcomes for men with pSCC remains a global challenge. Radical inguinal lymph node dissection remains the gold standard for diagnosing and curing N1 disease. Although many promising developments are on the horizon, high-level evidence is required to guide therapy.
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Affiliation(s)
- Jonathan S O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, The Royal Melbourne Hospital
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Peter MacCallum Cancer Centre
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
| | - Brian D Kelly
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, Eastern Health
| | - Justin Chee
- MURAC Health, East Melbourne
- Department of Urology, Alfred Health
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, The Royal Melbourne Hospital
- EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Victoria, Australia
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12
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Savoie PH, Murez T, Neuville P, Ferretti L, Rocher L, Van Hove A, Camparo P, Fléchon A, Branger N, Rouprêt M. French AFU Cancer Committee Guidelines - Update 2022-2024: penile cancer. Prog Urol 2022; 32:1010-1039. [PMID: 36400476 DOI: 10.1016/j.purol.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 07/24/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To update French oncology guidelines concerning penile cancer. METHODS Comprehensive Medline search between 2020 and 2022 upon diagnosis, treatment and follow-up of testicular germ cell cancer to update previous guidelines. Level of evidence was evaluated according to AGREE-II. RESULTS Epidermoid carcinoma is the most common penile cancer histology. Physical examination is mandatory to define local and inguinal nodal cancer stage. MRI with artificial erection can help to assess deep infiltration in cases of organsparing intention. Node negative patients (defined by palpation and imaging) will present micro nodal metastases in up to 25% of cases. Invasive lymph node assessment is thus advocated except for low risk patients. Sentinel node dynamic biopsy is the first line technique. Modified bilateral inguinal lymphadenectomy is an option with higher morbidity. 18-FDG-PET is recommended in patients with palpable nodes. Chest, abdominal and pelvis computerized tomography is an option. Fine needle aspiration (when positive) is an easy way to assess inguinal palpable node pathological involvement. Its results determine the type of lymphadenectomy to be performed (for diagnostic or curative purposes). Treatment is mostly surgical. Free margins status is essential, but it also has to be organ-sparing when possible. Brachytherapy and topic agents can cure in selected cases. Lymph node assessment should be synchronous to the removal of the tumour when possible. Limited inguinal lymph node involvement (pN1 stage) can be cured with the only lymphadenectomy. In case of larger lymph node stage, one should consider multidisciplinary treatment including chemotherapy and inclusion in a trial. CONCLUSIONS Penile cancer needs demanding surgery to be cured, surrounded by chemotherapy in node positive patients. Lymph nodes involvement is a major prognostic factor. Thus, inguinal node assessment cannot be neglected.
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Affiliation(s)
- P H Savoie
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service de chirurgie urologique, hôpital d'instruction des armées Sainte-Anne, 2, boulevard Sainte-Anne, BP 600, 83800 Toulon Cedex 09, France.
| | - T Murez
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et de transplantation rénale, CHU de Montpellier, 371 avenue du Doyen-Gaston-Giraud, 34295 Montpellier Cedex 5, France
| | - P Neuville
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie, CHU de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France
| | - L Ferretti
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; MSP Bordeaux Bagatelle, 203, route de Toulouse, 33401 Talence, France
| | - L Rocher
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service de radiologie, hôpital Antoine-Béclère, APHP, 157, rue de la Porte-de-Trivaux, 92140 Clamart, France; Université Paris-Saclay, BIOMAPS, 63, avenue Gabriel-Péri, 94270 Le Kremlin-Bicêtre, France
| | - A Van Hove
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Hôpital Européen, 6, rue Désirée-Clary, 13003 Marseille, France
| | - P Camparo
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Institut de pathologie des Hauts-de-France, 51, rue Jeanne-d'Arc, 80000 Amiens, France
| | - A Fléchon
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - N Branger
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Institut Paoli-Calmettes, 232, Boulevard Sainte Marguerite, 13273 Marseille, France
| | - M Rouprêt
- Comité de Cancérologie de l'Association française d'urologie, groupe organes génitaux externes, Maison de l'urologie, 11, rue Viète, 75017 Paris, France; Service d'urologie et transplantation rénale, hôpital européen Georges-Pompidou, AP-HP, 20, rue Leblanc, 75015 Paris, France
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13
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Belbina SH, Gereta S, Schmolze MR, Bradford JM, Yang C, Laviana AA. A Rare Case of Penile Mucosal Melanoma. Urology 2022; 169:e13-e15. [PMID: 35926663 DOI: 10.1016/j.urology.2022.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/06/2022] [Accepted: 07/18/2022] [Indexed: 11/20/2022]
Affiliation(s)
| | - Sofia Gereta
- Dell Medical School at the University of Texas, Austin, TX
| | - Mia Rose Schmolze
- The University of Texas Rio Grande Valley School of Medicine, Edinburg, TX
| | | | | | - Aaron A Laviana
- Dell Medical School at the University of Texas, Austin, TX; Department of Surgery and Perioperative Care, University of Texas at Austin Dell Seton Medical Center, Austin, TX.
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14
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Winkelmann R, Bankov K, von der Grün J, Cinatl J, Wild PJ, Vallo S, Demes M. The routine use of LCD-Array hybridisation technique for HPV subtyping in the diagnosis of penile carcinoma compared to other methods. BMC Urol 2022; 22:10. [PMID: 35093044 PMCID: PMC8801096 DOI: 10.1186/s12894-022-00962-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Routine human papillomavirus (HPV) testing is performed in cervival cancer and is required for classification of some head and neck cancers. In penile cancer a statement on HPV association of the carcinoma is required. In most cases p16 immunohistochemistry as a surrogate marker is applied in this setting. Since differing clinical outcomes for HPV positive and HPV negative tumors are described we await HPV testing to be requested more frequently by clinicians, also in the context of HPV vaccination, where other HPV subtypes are expected to emerge. METHOD Therefore, a cohort of archived, formalin-fixed paraffin embedded (FFPE) penile neoplasias was stained for p16 and thereafter tested for HPV infection status via PCR based methods. Additionally to Sanger sequencing, we chose LCD-Array technique (HPV 3.5 LCD-Array Kit, Chipron; LCD-Array) for the detection of HPV in our probes expecting a less time consuming and sensitive HPV test for our probes. RESULTS We found that LCD-Array is a sensitive and feasible method for HPV testing in routine diagnostics applicable to FFPE material in our cohort. Our cohort of penile carcinomas and carcinomas in situ was associated with HPV infection in 61% of cases. We detected no significant association between HPV infection status and histomorphological tumor characteristics as well as overall survival. CONCLUSIONS We showed usability of molecular HPV testing on a cohort of archived penile carcinomas. To the best of our knowledge, this is the first study investigating LCD-Array technique on a cohort of penile neoplasias.
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Affiliation(s)
- Ria Winkelmann
- Dr. Senckenberg Institute of Pathology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany.
| | - Katrin Bankov
- Dr. Senckenberg Institute of Pathology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Jens von der Grün
- Department of Radiation Oncology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Jindrich Cinatl
- Institute of Medical Virology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Peter J Wild
- Dr. Senckenberg Institute of Pathology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Stefan Vallo
- Institute of Medical Virology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
| | - Melanie Demes
- Dr. Senckenberg Institute of Pathology, University of Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany
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15
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Tosh JM, Jindal R, Mittal A, Panwar VK. Acquired scrotal lymphangiectasia, a long-term sequela of penile carcinoma: diagnosis an enigma. BMJ Case Rep 2022; 15:e246376. [PMID: 35022202 PMCID: PMC8756285 DOI: 10.1136/bcr-2021-246376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 11/03/2022] Open
Abstract
Acquired lymphangiectasia is an unique entity encountered by an urologist which is marked by occlusion of lymphatics associated with abnormal permanent dilation of cutaneous lymphatics. There is presence of thin-walled ectatic vessels in the superficial and mid dermis, which develops later in life. Trauma, infection, radiation or surgery are important causes of this rare aetiology. Diagnosis is always demanding, as it closely resembles many benign aetiology. Meticulous decision-making and appropriate treatment should be chosen for the management.
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Affiliation(s)
- Jyoti Mohan Tosh
- Department of Urology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | - Rashmi Jindal
- Department of Dermatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
| | - Ankur Mittal
- Department of Urology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
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16
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Fenech M, Pisani D, Camilleri DJ. Primary high-grade diffuse large B-cell lymphoma of the glans penis. BMJ Case Rep 2021; 14:e243844. [PMID: 34772674 PMCID: PMC8593726 DOI: 10.1136/bcr-2021-243844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 11/03/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) of the penis is a rare haematological malignancy, with less than 30 cases being reported in the literature. Our case mentions a 57-year-old man who presented with a penile lesion that was diagnosed as DLBCL on histological biopsy. Targeted investigation and proper diagnosis are essential to distinguish it from squamous cell carcinoma (SCC) of the glans, which presents similarly. Since guidelines are not available, the author compared different management mentioned in case reports and the outcome was noted. Chemotherapy, radiotherapy and surgery were the treatment modalities most used; out of which, chemotherapy had the most successful outcome. On the other hand, surgery is the preferred modality in SCC of the penis. This further consolidates the need for guidelines with regard to proper diagnosis and management of this malignancy.
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Affiliation(s)
- Marylou Fenech
- Haematology Department, Mater Dei Hospital, Msida, Malta
| | - David Pisani
- Pathology Department, Mater Dei Hospital, Msida, Malta
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17
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Dahlstrom KR, Anderson KS, Guo M, Kwon MC, Messick CA, Pettaway CA, Asomaning N, Hopper M, Price A, Xu L, Day AT, Gillenwater AM, Sturgis EM. Screening for HPV-related oropharyngeal, anal, and penile cancers in middle-aged men: Initial report from the HOUSTON clinical trial. Oral Oncol 2021; 120:105397. [PMID: 34182223 DOI: 10.1016/j.oraloncology.2021.105397] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND The Human papillomavirus (HPV)-related Oropharyngeal and Uncommon Cancers Screening Trial of Men (HOUSTON) was designed to determine the prevalence of IgG antibodies to HPV type 16 E proteins (HPV16EAbs), to screen for persistence of HPV and/or detect HPV-related premalignancies and cancers, and to assess acceptance of screening among middle-aged men. METHODS HOUSTON consists of a cross-sectional study and a longitudinal cohort study of men aged 50-64 years. Serologic HPV16EAb status and oral rinse HPV16 status were determined. All HPV16EAb-positive (HPV16EAb+) men and a matched cohort of HPV16EAb-negative (HPV16EAb-) men as well as all oral rinse HPV16-positive (HPV16+) men were included in the longitudinal study (blinded to their results) and underwent oropharyngeal screening every 6 months as well as one-time anal and penile screening. RESULTS Of 553 men enrolled in the cross-sectional study, six (1.1%) were HPV16EAb+ (two were also oral rinse HPV16+), and 41 (7.4%) were HPV16EAb- but oral rinse HPV16+. These 47 men, along with five matched controls, were invited to participate in the longitudinal study, and 42 (81%) agreed and completed baseline in-person screening, with 93% and 90% completeing 6-month and 12-month follow-up visits. One HPV16EAb+ (also oral rinse HPV16+) man, who declined participation in the longitudinal study, presented 4 months after enrollment with an early-stage HPV16-related pharyngeal cancer. Additionally, one HPV16EAb+ (oral rinse HPV16-) man and two oral rinse HPV16+ (HPV16EAb-) men were diagnosed with oncogenic HPV-associated anal dysplasia. CONCLUSIONS This biomarker panel deserves further prospective study to explore potential utility for HPV-related cancer screening among men.
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Affiliation(s)
- Kristina R Dahlstrom
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Karen S Anderson
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Ming Guo
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael C Kwon
- Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Craig A Messick
- Department of Colon and Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Curtis A Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Nancy Asomaning
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Marika Hopper
- Center for Personalized Diagnostics, The Biodesign Institute, Arizona State University, Tempe, AZ, United States
| | - Anthony Price
- Department of Gynecologic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Li Xu
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Andrew T Day
- Department of Otolaryngology - Head and Neck Surgery, The University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Ann M Gillenwater
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Erich M Sturgis
- Department of Otolaryngology - Head and Neck Surgery, Baylor College of Medicine, Houston, TX, United States.
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18
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Abstract
Penile squamous cell carcinoma (PSCC) is a rare cancer, with approximately 2000 new cases in the United States and 35,000 globally every year. Multiple risk factors are involved in PSCC, but most importantly, the high-risk human papillomavirus infection is thought to be present in approximately 50% of cases. Penile squamous cell carcinoma presents as localized or locally advanced disease. Multiple prognostic markers have been explored over the past 3 decades, but lymph node status remains the strongest predictor of clinical outcomes. Surgical decisions are based on the primary tumor pathologic findings, nodal clinical examination, and imaging results. Most patients with high-risk advanced PSCC benefit from a multimodal treatment approach combining chemotherapy with consolidation surgical treatment. The role of neoadjuvant chemotherapy with radiation therapy has not been well explored in PSCC. Prospective clinical studies, like the International Penile Advanced Cancer Trial, have been launched to provide high-level evidence for multimodal treatment. The International Penile Advanced Cancer Trial is the first randomized clinical trial among patients with PSCC and is currently accruing, with the expectation to generate results in 2023. Unfortunately, most patients with high-risk locally advanced PSCC will have relapsed or refractory cancer after cisplatin-based combination chemotherapy. These patients have dismal outcomes with salvage chemotherapy, highlighting the major unmet need to expand our knowledge of the disease's biology and develop clinical trials that use novel systemic agents. This narrative review synthesizes relevant publications retrieved from PubMed. Our aim is to discuss current approaches in the management of PSCC, summarize ongoing efforts to improve care, and identify future areas for enhancing our understanding of the disease.
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Affiliation(s)
- Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL. https://twitter.com/JadChahoud
| | - Manish Kohli
- Department of Genitourinary Oncology, Huntsman Cancer Institute, Salt Lake City, UT
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
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Abstract
PURPOSE OF REVIEW To review the most current literature on how the treatment for penile cancer can affect quality of life and to discuss current treatment options to overcome sexual dysfunction and ultimately improve patient wellbeing. RECENT FINDINGS Multiple medical and surgical therapies exist to address the high incidence of sexual dysfunction following penile cancer treatment. Advancements and refinements in the neophalloplasty, penile prosthesis, and penile lengthening procedures have opened the door to improved long-term outcomes. Additionally, studies continue to highlight the severe psychological toll that penile cancer treatment can have on patients. We explore the potential options for addressing the inherent psychologic effects of these treatments and highlight the need for further research in this domain. Although rare, it is important for all urologists to be familiar with the treatments and post-treatment sequelae of penile cancer. Penile cancer is associated with dramatic decline in quality of life and sexual function. Multiple medical and surgical therapies exist that addresses these concerns. Additionally, urologists must also be mindful of the psychologic component regarding surgical disfigurement and the decline in sexual function.
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Affiliation(s)
- George Coba
- University of South Florida-Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL, 33612, USA
| | - Trushar Patel
- Department of Urology, University of South Florida Morsani College of Medicine, 2 Tampa General Circle, STC6, Tampa, FL, 33606, USA.
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20
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Valtueña J, Sánchez DR, Martínez-García G, Garayar-Cantero M, Barrutia-Etxebarría L, Hadi A, Hadi S, Manchado-López P, Garabito-Solovera EL. Solitary circumscribed neuroma of the glans penis. An unusual finding. Dermatol Online J 2020; 26:13030/qt3b10r3zk. [PMID: 33423423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 12/29/2020] [Indexed: 06/12/2023] Open
Abstract
Palisaded encapsulated neuroma is a rare, benign neural tumor. The involvement of the glans penis is rare; few cases have been reported. We present a 52-year-old man with a five-month course of a solitary painless lesion of the glans penis. Full excision of the nodule was performed. Histopathological and immunohistochemical analyses and examination was consistent with a palisaded encapsulated neuroma. We describe one of a few existing cases of this kind of tumor in the glans penis.
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Affiliation(s)
- J Valtueña
- Department of Dermatology, Hospital Clinico Universitario de Valladolid, Valladolid.
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21
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Ramos MC, Oliveira FBD, Antonello VS, Boff AL. Case for diagnosis. Penile lesion in HIV-negative patient. An Bras Dermatol 2020; 95:655-657. [PMID: 32747011 PMCID: PMC7562993 DOI: 10.1016/j.abd.2020.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 03/28/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | - Ana Leticia Boff
- Dermatology Service, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
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22
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Lee TG, Son SM, Kim MJ, Lee SJ. Penile metastasis in rectal cancer with pathologic complete response after neoadjuvant chemoradiotherapy: The first case report and literature review. Medicine (Baltimore) 2020; 99:e21215. [PMID: 32702890 PMCID: PMC7373531 DOI: 10.1097/md.0000000000021215] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
RATIONALE Penile metastasis in rectal cancer is very rare and often originates from prostatic or bladder cancer. The prognosis of penile metastasis is poor and its treatments are more often palliative than curative due to association with disseminated metastases. Pathologic complete response (pCR) in rectal cancer with neoadjuvant chemoradiotherapy (CRT) has been shown to be surrogate marker of favorable long-term outcomes and currently has no report of penile metastasis. Here, we first report isolated penile metastasis in rectal cancer with pCR after neoadjuvant CRT. PATIENT CONCERN The patient was a 74-year-old male with metastasis to the glans penis from rectal cancer diagnosed 9 months after abdominoperineal resection. Physical examination revealed palpable multiple nodules on the glans penis. DIAGNOSIS Penile biopsy revealed metastatic carcinoma from the rectal cancer. INTERVENTION Chemotherapy was started as soon as possible, because patient suffered urinary discomfort by rapid growing metastatic lesions. He is currently receiving palliative chemotherapy with modified FOLFOX-6 (mFOLFOX-6; oxaliplatin with 5-fluorouracil and folinic acid) plus bevacizumab. OUTCOME The patient is still alive 4 months after diagnosis with markedly decreased metastatic lesions. LESSON We propose that although penile metastasis in rectal cancer with pCR after preoperative neoadjuvant CRT is extremely rare, it might help to start early palliative chemotherapy and clinicians should be aware of this possibility.
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Affiliation(s)
| | - Seung-Myoung Son
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Republic of Korea
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23
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Fraile A, Moncada Iribarren I, Chantada Abal V, Fernández-Pascual E, Romero Otero J, Alonso-Isa M, Lledó E, Egui-Rojo A, García-Baquero R, Torremadé J, Sarquella J, Fes Ascanio E, Cruz N, Martínez-Jabaloyas JM, Luján S, García Cruz E, Martínez-Salamanca JI. [Andrology and penile cancer. Recommendations during COVID-19 pandemia.]. ARCH ESP UROL 2020; 73:395-404. [PMID: 32538811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE The COVID-19 pandemic which has affected Spain since the beginning of 2020 compels us to determine recomendations for the practice of Andrology in present times. MATERIALS AND METHODS A web search is carried out in English and Spanish and a joint proposal is defined by experts in Andrology from different regions of Spain. RESULTS Most diagnostic and therapeutic procedures in Andrology can be safey postponed during the COVID-19 pandemic. Online consultations and outpatient surgeries must be encouraged. Andrologic emergencies and penile cancer management should be considered high priority, and should be diagnosed and treated promptly even in the most severe phases of the pandemic.
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Affiliation(s)
- Agustín Fraile
- Sección de Patología Prostática, Andrología y Urología Reconstructiva. Servicio de Urología. Hospital Universitario Ramón y Cajal. Lyx Instituto de Urología. Madrid. España
| | | | | | - Esaú Fernández-Pascual
- Servicio de Urología. Hospital Universitario La Paz. Lyx Instituto de Urología. Universidad Francisco de Vitoria. Madrid. España
| | - Javier Romero Otero
- Orcid 0000-0002-0666-5105. Responsable Andro-Cirugía Reconstructiva. HU.12 Octubre. Jefe Servicio Urología HU HM Montepríncipe. Jefe Servicio Urología HU HM Puerta del Sur. Profesor Urología San Pablo CEU. Madrid. España
| | - Manuel Alonso-Isa
- Servicio de Urología. Hospital Universitario 12 de Octubre. Madrid. España
| | - Enrique Lledó
- Coordinador Andrología y Cirugía Reconstructiva uretro-genital masculina. Servicio de Urología. Hospital Universitario Gregorio Marañón. Universidad Complutense Madrid. Madrid. España
| | | | - Rodrigo García-Baquero
- Unidad de Andrología - Cirugía Reconstructiva Urogenital. Servicio de Urología. Hospital Universitario Puerta del Mar. Cádiz. España
| | - Jose Torremadé
- Servicio de Urología. Hospital Universitari de Bellvitge. BarcelonaEspaña
| | | | | | - Natalio Cruz
- Director Médico ANDROMEDI. Andrología y Medicina Sexual. Sevilla. España
| | | | - Saturnino Luján
- Servicio de Urología. Hospital Universitari i Politècnic La Fe. Valencia. España
| | | | - Juan Ignacio Martínez-Salamanca
- Servicio de Urología. Hospital Puerta de Hierro. Lyx Instituto de Urología. Universidad Francisco de Vitoria. Madrid. España
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24
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Kim YH, Bang CH, Park YM, Lee JY, Lee JH. Multiple yellow-brown papules on the penis. Cutis 2020; 105:E44-E45. [PMID: 32717006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Yeong Ho Kim
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, South Korea
| | - Chul Hwan Bang
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, South Korea
| | - Young Min Park
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, South Korea
| | - Jun Young Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, South Korea
| | - Ji Hyun Lee
- Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, Catholic University of Korea, South Korea
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25
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Chu C, Chen K, Tan X, Lu J, Yang Y, Zhang Y, Yao K, Cao Y. Prevalence of human papillomavirus and implication on survival in Chinese penile cancer. Virchows Arch 2020; 477:667-675. [PMID: 32430598 DOI: 10.1007/s00428-020-02831-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/07/2020] [Accepted: 04/27/2020] [Indexed: 12/17/2022]
Abstract
We assessed the prevalence of HPV DNA in a large series of Chinese penile cancer and examine its association with the histological subtype, p16INK4a expression, and prognosis. We pathologically categorized 226 invasive penile squamous cell carcinomas and assessed HPV genotyping by real-time PCR and p16INK4a immunohistochemistry. The results were correlated with histopathological and clinical parameters and disease-specific survival (DSS). HPV DNA was detected in 32.7% (74/226) of penile cancer cases. The most frequent genotype was HPV 16 (64/74, 86.5%), followed by HPV 18 (6/74, 8.1%). Fifty-nine (26.1%) cases were positive for the p16INK4a expression, and p16INK4a expression had a sensitivity of 56.8% (95% CI, 45.2-68.3%) and a specificity of 88.8% (95% CI, 83.8-93.9%) for defining HPV status. HPV DNA (P = 0.019), p16INK4a (P = 0.038), age (P = 0.018), grade of differentiation (P = 0.001), lymph nodes (P < 0.001), T stage (P < 0.001), M stage (P < 0.001), and lymphovascular invasion (LVI, P = 0.001) were prognostic factors for DSS. HPV-positivity (HR 0.334; 95% CI, 0.158-0.705, P = 0.004) was still a significant prognostic factor for DSS in the multivariate Cox regression model. HPV DNA was observed in one third of Chinese penile carcinoma cases. The p16INK4a expression can indicate high-risk human papillomavirus (HR-HPV). HPV-positive penile tumors confer a survival benefit over HPV-negative tumors.
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Affiliation(s)
- Chengbiao Chu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Keming Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Xingliang Tan
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jiangli Lu
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Yuanzhong Yang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - YiJun Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China
| | - Kai Yao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
| | - Yun Cao
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, 510060, People's Republic of China.
- Department of Pathology, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.
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26
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Hu J, Li H, He T, Deng H, Gong G, Cui Y, Liu P, Ren W, Li C, Chen J, Zu X. A nomogram incorporating PD-L1, NLR, and clinicopathologic features to predict inguinal lymph node metastasis in penile squamous cell carcinoma. Urol Oncol 2020; 38:641.e19-641.e29. [PMID: 32389428 DOI: 10.1016/j.urolonc.2020.04.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 03/30/2020] [Accepted: 04/04/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Accurate preoperative prediction of inguinal lymph node metastasis (LNM) aids in clinical decision making, especially for patients with penile cancer with clinically negative lymph nodes. We aim to develop a nomogram to predict the preoperative risk of LNM by incorporating clinicopathologic features and tumor biomarkers. METHODS Eighty-four patients with penile cancer with clinically negative lymph nodes were enrolled. The programmed death ligand 1 (PD-L1) expression profile was detected by immunohistochemistry. The neutrophil-to-lymphocyte ratio (NLR) was calculated based on parameters of a routine blood examination. Multivariate logistic regression analysis was utilized to construct predictive nomograms for LNM based on data of 64 patients. The nomogram performance was assessed for calibration, discrimination, and clinical use. RESULTS Tumor grade, lymphovascular invasion, PD-L1, and NLR were independent predictors of LNM. Then, 4 prediction models were constructed. Clinical model included tumor grade and lymphovascular invasion. NLR model was built by adding the NLR to clinical model. PD-L1 model was built by adding the PD-L1 to clinical model. Finally, a combined model was built by adding both PD-L1 and NLR to clinical model. Combined model showed the best performance compared with other models. It showed good discrimination with a C-index of 0.89, and good calibration. In addition, decision curve analysis suggested that model 4 was clinically useful. CONCLUSIONS We developed a nomogram that incorporated tumor grade, lymphovascular invasion, PD-L1, and NLR that could be conveniently used to predict the preoperative individualized risk of inguinal LNM in patients with penile cancer.
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Affiliation(s)
- Jiao Hu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Huihuang Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Tongchen He
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Hao Deng
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Guanghui Gong
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, China
| | - Yu Cui
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Peihua Liu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Wenbiao Ren
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Chao Li
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China
| | - Jinbo Chen
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, China.
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27
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Lindner AK, Schachtner G, Steiner E, Kroiss A, Uprimny C, Steinkohl F, Horninger W, Heidegger I, Madersbacher S, Pichler R. Organ-sparing surgery of penile cancer: higher rate of local recurrence yet no impact on overall survival. World J Urol 2020; 38:417-424. [PMID: 31062123 PMCID: PMC6994547 DOI: 10.1007/s00345-019-02793-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 04/26/2019] [Indexed: 12/29/2022] Open
Abstract
PURPOSE To report on the oncological outcome of organ-sparing surgery (OSS) compared to (total or partial) penectomy regarding recurrence patterns and survival in squamous cell carcinoma (SCC) of the penis. METHODS This was a retrospective study of all patients with penile SCC and eligible follow-up data of at least 2 years at our institution. Patients with tumors staged ≥ pT1G2 underwent invasive lymph node (LN) staging by dynamic sentinel-node biopsy or modified inguinal lymphadenectomy. Radical inguinal lymphadenectomy was performed when LNs were palpable at diagnosis and in those with a positive LN status after invasive nodal staging. Follow-up visits were assessed, and local, regional and distant recurrences were defined and analyzed. RESULTS 55 patients were identified with a mean follow-up of 63.7 months. Surgical management was OSS in 26 patients (47.2%) and partial or total penectomy in 29 cases (52.8%). Histopathological staging was: pTis (12.7%), pTa (16.3%), pT1a (18.2%), pT1b (5.5%), pT2 (29.1%) and pT3 (18.2%), respectively. Patients in the penectomy group were significantly older (mean 68 vs. 62 years; p = 0.026) with a higher rate of advanced tumor stage (≥ pT2: 44.8% vs. 11.5%; p = 0.002). The local recurrence rate was 42.3% (n = 11) following OSS compared to 10.3% (n = 3) after penectomy (p = 0.007). Kaplan-Meier curves showed no significant differences between the two groups regarding metastasis-free and overall survival. CONCLUSIONS OSS is associated with a higher local recurrence rate compared to penectomy, yet it has no negative impact on overall and metastasis-free survival.
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Affiliation(s)
| | - Gert Schachtner
- Department of Urology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Eberhard Steiner
- Department of Urology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Alexander Kroiss
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Christian Uprimny
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Fabian Steinkohl
- Department of Radiology, Medical University Innsbruck, Innsbruck, Austria
| | - Wolfgang Horninger
- Department of Urology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Isabel Heidegger
- Department of Urology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - Stephan Madersbacher
- Department of Urology, Kaiser Franz Josef Hospital, Sigmund Freud Private University, Vienna, Austria
| | - Renate Pichler
- Department of Urology, Medical University Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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28
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Reynoso Noverón N, Scavuzzo A, Santana Rios Z, Meneses-García A, Uscanga-Yépez J, Domínguez Castillo RE, Ochoa Sánchez A, Bolio Laviada FM, Granda González D, Martínez-Cervera P, Jiménez-Ríos MÁ. [Penile cancer in Mexico: Twenty years experience at a tertiary academic hospital.]. ARCH ESP UROL 2020; 73:11-18. [PMID: 31950918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The aim of this study was to report clinical features and management of penile cancer (CP) at the National Cancer Institute (INCan) of Mexico City over 20 years. MATERIALS AND METHODS We retrospectively reviewed the medical records of 405 cases of primary penile cancer (PC) treated at our institution between 1989 until 2015. Diagnosis, treatment and oncological outcomes are reported. RESULTS Clinicopathologic and demographic information was available for 375 patients (mean age, 56 ys). At diagnosis, 140 (37.3 %) patients were cN0, 71(18.9%) cN1, 164 (43.37%) cN2 and 33 (8%) cN3. 14% had metastatic disease (lung and bone). Initial treatment included partial penectomy (n=123; 33.6%), and total penectomy (n=126;33.6%). 138 (36.2%) patients with high risk disease underwent bilateral inguinal lymph node dissection. 8% (56) had positive lymph nodes. Kaplan-Meier survival analysis showed a 10-year CSS (cancer specific survival) rate of 70%. There was no significant difference in CSS when stratifying per age. Five-year CSS for pT1, pT2, pT3 and T4 was 96%, 88%, 58% y T4 0%, respectively. A difference in CSS was found between pT2 and pT3 (p=0.047). CONCLUSION The findings of our descriptive analysis provide information on natural history of penile cancer in Mexico. The surgical penile removal of the primary tumour remains standard of care. There was no difference in survival for age group.
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Affiliation(s)
- Nancy Reynoso Noverón
- Departamento de Epidemiologia. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Anna Scavuzzo
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Zael Santana Rios
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Abelardo Meneses-García
- Departamento de Epidemiologia. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Jaime Uscanga-Yépez
- Departamento de Posgrado. Escuela Nacional de Medicina del Instituto Tecnológico de Estudios Superiores de Monterrey. México
| | | | - Alsino Ochoa Sánchez
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Fernando M Bolio Laviada
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - David Granda González
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Pedro Martínez-Cervera
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
| | - Miguel Ángel Jiménez-Ríos
- Departamento de Urología Oncológica. Instituto Nacional de Cancerología de México. Cd. de México. México
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29
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Halstead NV, Cost NG, Hecht SL, Walker JP. Neurofibromatosis-1 and Rhabdomyosarcoma: An Unusual Recurrence. Urology 2019; 137:168-172. [PMID: 31794814 DOI: 10.1016/j.urology.2019.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 11/15/2019] [Accepted: 11/19/2019] [Indexed: 11/19/2022]
Abstract
Neurofibromatosis-1 has a known increased risk of malignancy with rhabdomyosarcoma occurring in up to 6% of patients. Here we report on an 8-year-old male with a history of Neurofibromatosis-1 and previously treated stage 3, group III bladder/prostate embryonal rhabdomyosarcoma (diagnosed at 18 months old) who presented with penile swelling concerning for priapism. Imaging and subsequent biopsy confirmed embryonal rhabdomyosarcoma of the penile corporal bodies. Penile rhabdomyosarcoma is exceedingly rare, with less than 15 case reports in the literature. Our patient received chemoradiation per D9803 with organ preserving local control and is doing well 3 months after treatment.
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Affiliation(s)
- Nadia V Halstead
- Department of Surgery, Division of Urology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO.
| | - Nicholas G Cost
- Department of Surgery, Division of Urology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
| | - Sarah L Hecht
- Department of Surgery, Division of Urology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
| | - Jonathan P Walker
- Department of Surgery, Division of Urology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO
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30
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Zhang S, Khosravi H, Cardis M, Jedrych J, Ho J, Bunimovich Y. A challenging diagnosis of penile sarcomatoid squamous cell carcinoma. Dermatol Online J 2019; 25:13030/qt0z03z1bj. [PMID: 31735007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 11/08/2019] [Indexed: 06/10/2023] Open
Abstract
We report a patient with penile sarcomatoid squamous cell carcinoma (SCC) initially misdiagnosed as condyloma acuminatum. Sarcomatoid SCC is a rare, aggressive, biphasic cancer that often presents a diagnostic challenge and carries a poor prognosis, especially after a delay in diagnosis. Although sarcomatoid SCC may exhibit a broad range of clinical features, the expression of p63 and keratin 34?E12 is a common finding. Our case highlights the importance of accurate clinicopathologic correlation to facilitate a timely diagnosis and management of this rare and highly aggressive malignancy.
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Affiliation(s)
- Sophia Zhang
- University of Pittsburgh School of Medicine, Pittsburgh, PA
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31
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Abstract
BACKGROUND Psychological stress of patients with penile cancer arises from the cancer diagnosis itself and the treatment consequences. In addition, there is cancer-specific distress. There is the chance of cure in localized stages and in those with limited regional lymph node metastases but this requires surgery and often adjuvant chemotherapy. This systematic review gives a summary of the existing literature to date. MATERIALS AND METHODS A critical database search using Medline was made in Ovid from 1946 to 2017, in the Cochrane Central Register of Controlled Trials (CENTRAL) and in the Web of Science from 1900 to 2017. This was complemented by a search of the World Health Organization's International Clinical Trials Registry Platform Search Portal and ClinicalTrials.gov. The reference lists of the included studies were manually searched for additional references. RESULTS Selected studies (n = 10) addressed the psychosocial effects of penile cancer treatment on quality of life and sexual function. Due to the heterogeneity of the study designs only a narrative description of the results was possible. Defects or mutilation due to penile cancer cause psychological distress in a significant number of patients. Organ-sparing interventions have a positive impact on quality of life and sexual function. CONCLUSION The external genitals are a focus of sexual identity. Mutilating treatment causes significant distress but organ-sparing treatment and reconstruction positively influence quality of life.
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Affiliation(s)
- D L Dräger
- Klinik und Poliklinik für Urologie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland.
| | - S Milerski
- Klinik und Poliklinik für Urologie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland
| | - K D Sievert
- Klinik und Poliklinik für Urologie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland
| | - O W Hakenberg
- Klinik und Poliklinik für Urologie, Universitätsmedizin Rostock, Schillingallee 35, 18057, Rostock, Deutschland
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32
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Grekova YN, Zilberberg NV, Toropova NP, Kuznetsova EI, Iglikov VA. [Lymphangioma of the penis]. Urologiia 2019:64-66. [PMID: 31162904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Lymphangioma circumscriptum (LC) is a rare, benign condition, predominantly characterized by the malformation of lymphatic skin vessels. The most common sites include the oral mucosa, tongue, skin of the extremities and torso. Lymphangioma of the penis is rare disease. In the paper a clinical case of cystic lymphangioma of the penis, which was initially diagnosed as herpes and human papillomavirus infection, is described. Early diagnosis of skin tumors of anogenital area allows to prescribe a timely therapy. After the CO2-laser vaporization there was no recurrence during the 6-month follow-up period.
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Affiliation(s)
- Y N Grekova
- ) Ural scientific research Institute of dermatology and immunopathology. Ekaterinburg, Russia
- ) Ural State Medical University Ekaterinburg, Russia
- ) Regional Skin and Venereologic Clinic No. 3, Chelyabinsk, Russia
| | - N V Zilberberg
- ) Ural scientific research Institute of dermatology and immunopathology. Ekaterinburg, Russia
- ) Ural State Medical University Ekaterinburg, Russia
- ) Regional Skin and Venereologic Clinic No. 3, Chelyabinsk, Russia
| | - N P Toropova
- ) Ural scientific research Institute of dermatology and immunopathology. Ekaterinburg, Russia
- ) Ural State Medical University Ekaterinburg, Russia
- ) Regional Skin and Venereologic Clinic No. 3, Chelyabinsk, Russia
| | - E I Kuznetsova
- ) Ural scientific research Institute of dermatology and immunopathology. Ekaterinburg, Russia
- ) Ural State Medical University Ekaterinburg, Russia
- ) Regional Skin and Venereologic Clinic No. 3, Chelyabinsk, Russia
| | - V A Iglikov
- ) Ural scientific research Institute of dermatology and immunopathology. Ekaterinburg, Russia
- ) Ural State Medical University Ekaterinburg, Russia
- ) Regional Skin and Venereologic Clinic No. 3, Chelyabinsk, Russia
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33
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Kamel MH, Khalil MI, Davis R, Spiess PE. Management of the Clinically Negative (cN0) Groin Penile Cancer Patient: A Review. Urology 2019; 131:5-13. [PMID: 31129195 DOI: 10.1016/j.urology.2019.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 01/05/2023]
Abstract
To determine the role of noninvasive, minimally invasive diagnostic modalities and current management recommendations for cN0 PNC, a literature review using PubMed and Web of Science search engines were conducted. We found that for predicting ILN+: physical exam has limitations, nomograms are not validated, conventional computerized tomography/magnetic resonance imaging/positron imaging tomography scans have minimal role, and dynamic sentinel lymph node biopsy is the most reliable minimally invasive modality. Adverse pathological features: G3, stage ≥ T2, presence of LVI, and rare histopathological variants are important predictors of ILN+ and their presence warrants prophylactic ILND or dynamic sentinel lymph node biopsy. In the absence of these adverse pathological features conservative management is justified.
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Affiliation(s)
- Mohamed H Kamel
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Mahmoud I Khalil
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Rodney Davis
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Philippe E Spiess
- Department of Genito-urinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
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34
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Ning WV, Bashey S, Cole C, Ngo B. Multiple eruptive syringomas on the penis. Cutis 2019; 103:E15-E16. [PMID: 31233587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Weihuang Vivian Ning
- Department of Dermatology, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Sameer Bashey
- Department of Dermatology, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, California, USA
| | - Christine Cole
- Center for Dermatology Care, Thousand Oaks, California, USA
| | - Binh Ngo
- Department of Dermatology, Keck School of Medicine, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, California, USA
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35
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Abstract
Penile cancer is a rare condition and can be very complex to manage. Advances in surgical techniques, imaging, pathological classification and patient pathways have led to improved patient care. The diagnosis of pre-malignant change, penile cancer and metastatic disease along with advances in their treatment are detailed in this review which aims to update clinicians from multiple specialties and countries on penile cancer.
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Affiliation(s)
- Maximilian J Johnston
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
- Department of Surgery & Cancer, Imperial College London, London, UK
| | - Raj Nigam
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
- Institute of Urology, University College London Hospitals, London, UK
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36
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St Claire K, Hoover A, Ashack K, Khachemoune A. Extramammary Paget disease. Dermatol Online J 2019; 25:13030/qt7qg8g292. [PMID: 31046904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 04/29/2019] [Indexed: 06/09/2023] Open
Abstract
In 1874, Sir James Paget first described Paget disease of the nipple, also known as mammary Paget disease. In 1889, extramammary Paget disease (EMPD) of the scrotum and penis was identified. Although mammary and extramammary Paget disease are both characterized by epidermal Paget cells and share a similar clinical presentation, their uniqueness lies in anatomical location and histogenesis. EMPD presents as an erythematous plaque on apocrine gland bearing areas (i.e. vulva, perineum, perianal region, scrotum, and penis) in older men and women. It can be a focal, multifocal, or an ectopic process. Immunohistochemical staining allows for differentiation between primary and secondary EMPD in addition to the many other disease entities that clinically resemble this malignancy. When diagnosing a patient with EMPD, a full history and physical should be performed given the possibility of an underlying malignancy. Surgical excision currently is first line therapy and the prognosis is often favorable. Recent advances within the field have examined the expression of chemokine receptors within tumors, which may be applicable in determining prognosis. This review addresses the history, epidemiology, pathogenesis, clinical presentation, histopathology, differential diagnosis, diagnosis, management, and new observations with respect to extramammary Paget disease.
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Affiliation(s)
| | | | | | - Amor Khachemoune
- Veterans Affairs Medical Center Brooklyn, Brooklyn, New York SUNY Downstate, Department of Dermatology, Brooklyn, New York.
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Mrinakova B, Ondrušová M, Švantnerová M, Ondruš D. Malignant Tumors of the Penis - Dia-gnostics and Therapy. Klin Onkol 2019; 32:31-39. [PMID: 30764627 DOI: 10.14735/amko201931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Penile cancer belongs to group of relatively rare malignancies. It represents, on average, 0.5-1% of all tumours in males globally and occurs predominantly in older individuals (> 65 years). The geographical distribution of malignant cancer of the penis is reported. A higher incidence is observed in less developed parts of the world, particularly in South America, Southeast Asia, and some areas of Africa (> 2.0/100,000). In Slovakia, there has been a recent increase in incidence (1.1/100,000 in 2011). Mortality has stabilized at 0.3/100,000 in recent years. Significant risk factors for malignant cancers include social and cultural habits and hygienic and religious practices. Important risk factors are inadequate hygiene of the foreskin sac, phimosis, human papillomavirus infection, sexual promiscuity, smoking, genital infections, and a low socio-economic and educational status. PURPOSE The present paper provides an overview of pathology, symptomatology, diagnostic approaches, and classification of the extent of the disease. Treatment of the primary tumour depends on the extent of the disease and includes topical treatment, photodynamic treatment, cryoablation, laser photocoagulation, conservative surgical treatment, especially circumcision, and even radical treatment - penile amputation with perineal urethrostomy. An important part of the management of this malignancy is surgical treatment of metastases in inguinal lymph nodes. The article devotes more attention to non-surgical treatment modalities, in particular radiotherapy (external and brachytherapy) and systemic therapy (chemotherapy and biologic therapy), offering an overview of the indications and regimens in the adjuvant, neoadjuvant and palliative approaches, with and without concomitant chemoradiotherapy, and describes possible adverse effects of the treatments. Conclusion: Patients with penile cancer should be concentrated in centres that have abundant experience in the diagnosis and treatment of this disease. Key words penile cancer - surgical treatment - radiotherapy - chemotherapy - biologic therapy The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 12. 11. 2018 Accepted: 12. 12. 2018.
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Zhou X, Qin Y, Song NH. [Progress in the diagnosis and surgical treatment of penile cancer: A systematic review]. Zhonghua Nan Ke Xue 2018; 24:1036-1040. [PMID: 32212480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The incidence of penile cancer is relatively low among the tumors of the urological system, but it may severely affect the mental and physiological health of the patients. In recent years, more and more evidence has lent support to the role of organ-sparing surgery in the treatment of early-stage penile cancer, which has the advantages of maintaining urinary and sexual intercourse functions and desirable penile appearance. Meanwhile, videoscope- and robot-assisted dissection of the lymph nodes has been applied clinically, though whether it could reduce postoperative complications remains to be further observed. This systematic review updates the diagnosis and surgical treatment of penile cancer.
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Affiliation(s)
- Xiang Zhou
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yuan Qin
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ning-Hong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, China
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Walther Hakenberg O, Louise Dräger D, Erbersdobler A, Maik Naumann C, Jünemann KP, Protzel C. The Diagnosis and Treatment of Penile Cancer. Dtsch Arztebl Int 2018; 115:646-652. [PMID: 30375327 PMCID: PMC6224543 DOI: 10.3238/arztebl.2018.0646] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 12/03/2017] [Accepted: 06/04/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND The incidence of penile cancer in Europe lies in the range of 0.9 to 2.1 cases per 100 000 persons per year. Carcinogenesis is associated with human papilloma virus (HPV) infection and with chronic inflammation. METHODS This review is based on publications (2010-2017) retrieved by a selective search in PubMed and EMBASE and on the guidelines of the European Association of Urology, the European Society of Medical Oncology, the National Comprehensive Cancer Network, and the National Institute for Health and Care Excellence (NICE). RESULTS 95% of cases of penile cancer are accounted for by squamous cell carcinoma, whose numerous subtypes have different clinical courses. Chronic preputial inflammation due to phimosis or lichen sclerosus is often associated with penile cancer. Circumcision lowers the risk of penile cancer (hazard ratio: 0.33). Maximally organ-preserving surgery with safety margins of no more than a few millimeters is the current therapeutic standard, because a local recurrence, if it arises, can still be treated locally with curative intent. Local radiotherapy can be performed in early stages. Lymphogenic metastasis must be treated with radical lymphadenectomy and adjuvant chemotherapy. Patients with clinically unremarkable inguinal lymph nodes nonetheless need invasive lymph node staging because of the high rate of lymphogenic micrometastasis. CONCLUSION Penile cancer is curable in all early stages with the appropriate treatment, but its prognosis depends crucially on the proper management of the regional (i.e., inguinal) lymph nodes. In many countries, the treatment of this rare disease entity has been centralized.
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Affiliation(s)
| | | | | | - Carsten Maik Naumann
- Department of Urology and Pediatric Urology, Schleswig-Holstein University Hospital (UK-SH), Campus Kiel, Kiel, Germany
| | - Klaus-Peter Jünemann
- Department of Urology and Pediatric Urology, Schleswig-Holstein University Hospital (UK-SH), Campus Kiel, Kiel, Germany
| | - Chris Protzel
- Department of Urology, University Medical Center Rostock; Rostock, Germany
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Daklan S, Daryakar A. Lymphangioma circumscriptum of glans penis: a report of two cases. Dermatol Online J 2018; 24:13030/qt9pr342qv. [PMID: 30677855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 10/02/2018] [Indexed: 06/09/2023] Open
Abstract
Lymphangioma circumscriptum is a developmental anomaly of lymphatic vessels, which appear as aggregates of clear or hemorrhagic vesicles on the skin or mouth. Glans penis involvement is very uncommon. Because of the sensitivity of the area, possible functional, cosmetic, or psychologic disturbances can result. Lymphangioma circumscriptum is rarely found on this location; hence, vigilance and awareness of this entity is necessary for a swift and proper diagnosis. Two cases are presented on the account of their rarity and unique representation.
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ottenhof SR, Djajadiningrat RS, Thygesen HH, Jakobs PJ, Jóźwiak K, Heeren AM, de Jong J, Sanders J, Horenblas S, Jordanova ES. The Prognostic Value of Immune Factors in the Tumor Microenvironment of Penile Squamous Cell Carcinoma. Front Immunol 2018; 9:1253. [PMID: 29942303 PMCID: PMC6004546 DOI: 10.3389/fimmu.2018.01253] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/18/2018] [Indexed: 12/26/2022] Open
Abstract
The host's immune system plays a pivotal role in many tumor types, including squamous cell carcinomas (SCCs). We aim to identify immunological prognosticators for lymph node metastases (LNM) and disease-specific survival (DSS) in penile SCC. For this retrospective observational cohort study, penile SCC patients (n = 213) treated in the Netherlands Cancer Institute, were selected if sufficient formalin-fixed, paraffin-embedded tumor material was available. Analysis included previously described high-risk human papilloma virus (hrHPV) status, immunohistochemical scores for classical and non-classical human leukocyte antigen (HLA) class I, programmed death ligand-1 (PD-L1) expression, and novel data on tumor-infiltrating macrophages and cytotoxic an regulatory T-cells. Clinicopathological characteristics and extended follow-up were also included. Regression analyses investigated relationships of the immune parameters with LNM and DSS. In the total cohort, diffuse PD-L1 tumor-cell expression, CD163+ macrophage infiltration, non-classical HLA class I upregulation, and low stromal CD8+ T-cell infiltration were all associated with LNM. In the multivariable model, only tumor PD-L1 expression remained a significant predictor for LNM (odds ratio (OR) 2.8, p = 0.05). hrHPV negativity and diffuse PD-L1 tumor-cell expression were significantly associated with poor DSS and remained so upon correction for clinical parameters [hazard ratio (HR) 9.7, p < 0.01 and HR 2.8, p = 0.03]. The only immune factor with different expression in HPV+ and HPV- tumors was PD-L1, with higher PD-L1 expression in the latter (p = 0.03). In the HPV- cohort (n = 158), LNM were associated with diffuse PD-L1 tumor-cell expression, high intratumoral CD163+ macrophage infiltration, and low number of stromal CD8+ T-cells. The first two parameters were also linked to DSS. In the multivariable regression model, diffuse PD-L1 expression remained significantly unfavorable for DSS (HR 5.0, p < 0.01). These results emphasize the complexity of the tumor microenvironment in penile cancer and point toward several possible immunotherapy targets. Here described immune factors can aid risk-stratification and should be evaluated in clinical immunotherapy studies to ultimately lead to patient tailored treatment.
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Affiliation(s)
| | - Rosa Sanne Djajadiningrat
- Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
- Department of Urology, HagaZiekenhuis, Hague, Netherlands
| | - Helene Hoegsbro Thygesen
- Department of Biometrics, Netherlands Cancer Institute, Amsterdam, Netherlands
- Statistics, Department of Conservation, Hamilton, New Zealand
| | | | - Katarzyna Jóźwiak
- Department of Epidemiology and Biostatistics, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Anne Marijne Heeren
- Center for Gynecologic Oncology Amsterdam (CGOA), VU University Medical Center, Amsterdam, Netherlands
| | - Jeroen de Jong
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Joyce Sanders
- Department of Pathology, Netherlands Cancer Institute, Amsterdam, Netherlands
| | - Simon Horenblas
- Department of Urology, Netherlands Cancer Institute, Amsterdam, Netherlands
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Coelho RWP, Pinho JD, Moreno JS, Garbis DVEO, do Nascimento AMT, Larges JS, Calixto JRR, Ramalho LNZ, da Silva AAM, Nogueira LR, de Moura Feitoza L, Silva GEB. Penile cancer in Maranhão, Northeast Brazil: the highest incidence globally? BMC Urol 2018; 18:50. [PMID: 29843769 PMCID: PMC5975591 DOI: 10.1186/s12894-018-0365-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 05/14/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND The objectives of this study were to determine the minimum incidence of penile cancer in the poorest Brazilian state, and to describe the epidemiologic and clinical characteristics of patients diagnosed with the disease. METHODS A retrospective study of 392 patients diagnosed with penile cancer in the three most important referral center in the state was conducted during 2004-2014. RESULTS The age-standardized incidence was 6.15 per 100,000 and the crude annual incidence was 1.18 per 100,000. More than half (61.1%) of the tumors were histological grades 2 and 3, and 66.4% of tumors were classified as at least stage T2. The average age of patients was 58.6 ± 15.7 years (range, 18 to 103 years), with 20.8% of patients ≤40 years of age at diagnosis. The vast majority underwent penectomy (93%). Only 41.8% underwent lymphadenectomy, 58 patients (14.8%) received chemotherapy, and 54 patients (13.8%) received radiotherapy. Stage 3/4 and vascular invasion were statically significant at disease-free survival analysis. CONCLUSION The state of Maranhão has the highest incidence of penile cancer in Brazil and globally. Tumors are locally advanced and at the time of diagnosis, and there is a high frequency among young individuals. Patients have a low socioeconomic status, making it difficult to complete treatment and receive appropriate follow-up.
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Affiliation(s)
| | - Jaqueline Diniz Pinho
- Federal University of Pará, Brazil, Gov. José Malcher Avenue, Belém, 66055-260, Brazil
| | - Janise Silva Moreno
- Aldenora Bello Cancer Hospital, Seroa da Mota Street, Apeadouro, São Luís, 65031-630, Brazil
| | | | | | - Joyce Santos Larges
- University Hospital of Federal University of Maranhão, Barão de Itapari Street, Centro, São Luís, Brazil
| | - José Ribamar Rodrigues Calixto
- Federal University of Maranhão, São Luís, Brazil, dos Portugueses Avenue, Bacanga, São Luís, 65080-805, Brazil
- University Hospital of Federal University of Maranhão, Barão de Itapari Street, Centro, São Luís, Brazil
| | - Leandra Naira Zambelli Ramalho
- Department of Radiology and Pathology, Ribeirão Preto Medical School of University of São Paulo, Bandeirantes Avenue, Monte Alegre, Ribeirão Preto, 14049-900, Brazil
| | - Antônio Augusto Moura da Silva
- Public Heath Departament, Federal University of Maranhão, São Luís, Brazil, dos Portugueses Avenue, Bacanga, São Luís, 65080-805, Brazil
| | | | - Laisson de Moura Feitoza
- Federal University of Maranhão, São Luís, Brazil, dos Portugueses Avenue, Bacanga, São Luís, 65080-805, Brazil
| | - Gyl Eanes Barros Silva
- University Hospital of Federal University of Maranhão, Barão de Itapari Street, Centro, São Luís, Brazil.
- Department of Radiology and Pathology, Ribeirão Preto Medical School of University of São Paulo, Bandeirantes Avenue, Monte Alegre, Ribeirão Preto, 14049-900, Brazil.
- Ribeirão Preto Medical School - USP, Av. Bandeirantes, 3900, Ribeirão Preto, SP, 14048-900, Brazil.
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Abstract
RATIONALE Melanoma in situ of the penis is very rare and there are no clear guidelines for its surgical treatment. PATIENT CONCERNS The authors describe the case of a 69-year-old man who presented with an asymptomatic brown macula on his glans penis and foreskin that appeared about 8 years earlier, enlarged in the last few months. DIAGNOSES A diagnostic biopsy showed the characteristics of a melanoma in situ. INTERVENTIONS The authors decided to excise the lesion keeping a healthy margin of 1 cm all over around except close to the urethral meatus, where it was impossible, and where only 5 mm of free margin was excised. A full thickness mucosal graft from oral cavity was performed to repair the defect. OUTCOMES No recurrence or metastasis occurred during 50 months after the operation. LESSONS Considering that at the sixth clinical follow-up the patient was alive and disease free at 50 months after surgery, the chosen treatment has proved successful.
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Affiliation(s)
- Roberto Baraziol
- Azienda Sanitaria Universitaria Integrata di Udine, Plastic Surgery Unit
| | - Mauro Schiavon
- Azienda Sanitaria Universitaria Integrata di Udine, Plastic Surgery Unit
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Marchi FA, Martins DC, Barros-Filho MC, Kuasne H, Busso Lopes AF, Brentani H, Trindade Filho JCS, Guimarães GC, Faria EF, Scapulatempo-Neto C, Lopes A, Rogatto SR. Multidimensional integrative analysis uncovers driver candidates and biomarkers in penile carcinoma. Sci Rep 2017; 7:6707. [PMID: 28751665 PMCID: PMC5532302 DOI: 10.1038/s41598-017-06659-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/19/2017] [Indexed: 01/24/2023] Open
Abstract
Molecular data generation and their combination in penile carcinomas (PeCa), a significant public health problem in poor and underdeveloped countries, remain virtually unexplored. An integrativemethodology combin ing genome-wide copy number alteration, DNA methylation, miRNA and mRNA expression analysis was performed in a set of 20 usual PeCa. The well-ranked 16 driver candidates harboring genomic alterations and regulated by a set of miRNAs, including hsa-miR-31, hsa-miR-34a and hsa-miR-130b, were significantly associated with over-represented pathways in cancer, such as immune-inflammatory system, apoptosis and cell cycle. Modules of co-expressed genes generated from expression matrix were associated with driver candidates and classified according to the over-representation of passengers, thus suggesting an alteration of the pathway dynamics during the carcinogenesis. This association resulted in 10 top driver candidates (AR, BIRC5, DNMT3B, ERBB4, FGFR1, PML, PPARG, RB1, TNFSF10 and STAT1) selected and confirmed as altered in an independent set of 33 PeCa samples. In addition to the potential driver genes herein described, shorter overall survival was associated with BIRC5 and DNMT3B overexpression (log-rank test, P = 0.026 and P = 0.002, respectively) highlighting its potential as novel prognostic marker for penile cancer.
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Affiliation(s)
| | - David Correa Martins
- Center of Mathematics, Computing and Cognition, Federal University of ABC - UFABC, Santo André, SP, Brazil
| | | | | | | | - Helena Brentani
- Department of Psychiatry, Medical School, University of Sao Paulo - USP, São Paulo, SP, Brazil
| | | | | | - Eliney F Faria
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | - Ademar Lopes
- A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Silvia Regina Rogatto
- Department of Urology, Faculty of Medicine, Sao Paulo State University - UNESP, Botucatu, SP, Brazil.
- Department of Clinical Genetics, Vejle Hospital and Institute of Regional Health, University of Southern Denmark, Odense, Denmark.
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Russell CM, Salami SS, Niemann A, Weizer AZ, Tomlins SA, Morgan TM, Montgomery JS. Minimally Invasive Inguinal Lymphadenectomy in the Management of Penile Carcinoma. Urology 2017; 106:113-118. [PMID: 28450202 DOI: 10.1016/j.urology.2017.04.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/10/2017] [Accepted: 04/14/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To report and analyze the outcomes of endoscopic inguinal lymph node dissection (E-ILND), inclusive of video endoscopic ILND (VEIL) and robotic-assisted ILND (RAIL) approaches, in the largest reported series to date. MATERIALS AND METHODS We retrospectively identified men with penile cancer who underwent E-ILND. Nodal resection volume, perioperative parameters, and postoperative complications were assessed and analyzed. A subset analysis of complications by tumor and operative characteristics was performed to determine the impact of these variables on complication rates. RESULTS A total of 34 E-ILND, comprising 7 VEIL and 27 RAIL limbs, were performed. Median nodal yield was 10.0 (interquartile range [IQR] 6.0-12.5) in all E-ILND limbs and 8.0 (IQR 13.0-23.0) in RAIL limbs. Median length of stay was 1 day (range 1-3) following E-ILND and RAIL procedures. The saphenous vein was spared in 57% (4/7) of VEIL and 100% (27/27) of RAIL limbs. Postoperative complications occurred in 33% (6/18) of E-ILND, including 21% (3/14) of RAIL patients. Median follow-up was 5.5 months (IQR 3.0-10.8), during which time 3 patients developed regional or distant metastases at a median duration of 1.7 months (IQR 0.9-3.9). CONCLUSION E-ILND is feasible from a technical standpoint, and our results demonstrate that lymph node counts are comparable with an open approach. Importantly, E-ILND has the potential to reduce complication rates and time to convalescence when compared with open ILND.
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Affiliation(s)
| | - Simpa S Salami
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Adam Niemann
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Alon Z Weizer
- Department of Urology, University of Michigan, Ann Arbor, MI
| | - Scott A Tomlins
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Todd M Morgan
- Department of Urology, University of Michigan, Ann Arbor, MI
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Aragon-Ching JB, Pagliaro LC. New Developments and Challenges in Rare Genitourinary Tumors: Non-Urothelial Bladder Cancers and Squamous Cell Cancers of the Penis. Am Soc Clin Oncol Educ Book 2017; 37:330-336. [PMID: 28561704 DOI: 10.1200/edbk_175558] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The diagnosis and treatment of rare genitourinary tumors is inherently challenging. The Rare Diseases Act of 2002 initially defined a rare disorder as one that affects fewer than 200,000 Americans. The lack of widely available clinical guidelines, limited research funding, and inaccessible clinical trials often lead to difficulty with treatment decisions to guide practitioners in rendering effective care for patients with rare genitourinary cancers. This article will discuss basic tenets of diagnosis and treatment as well as recent developments and clinical trials in rare non-urothelial bladder cancers and penile squamous cell cancers.
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Affiliation(s)
- Jeanny B Aragon-Ching
- From the Inova Schar Cancer Institute, Fairfax, VA; Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
| | - Lance C Pagliaro
- From the Inova Schar Cancer Institute, Fairfax, VA; Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
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48
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Cramer M, Dreyer D. [Condylomas turned out to be penis cancer]. Ugeskr Laeger 2016; 178:V67838. [PMID: 27506913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Abstract
Patients with penile lesions, such as virally induced papillomata, frequently present to genitourinary medicine clinics and general practitioners. Their diagnosis is usually based on clinical observation and biopsy is not generally undertaken. Penile lesions may rarely have a more sinister aetiology and represent metastatic spread from solid tumours arising at distant sites. Penile metastases arise most frequently from genitourinary cancers (prostate, bladder and kidney), but may also arise from tumours of the large bowel; other primary sites are extremely uncommon. We report the case of a patient presenting with penile metastases from rectal carcinoma arising during third-line chemotherapy for metastatic disease.
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Affiliation(s)
- R Cathomas
- Department of Medical Oncology, Southampton University Hospitals NHS Trust, Tremona Road, Southampton SO16 6YD, UK
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50
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Wang HZ, Liu ZH, Liu JB, Ren SQ, Zhao T, Zeng H, Li X. [Immediate Inguinal Lymph Node Dissection Improves Survival in Patients of Penile Cancer]. Sichuan Da Xue Xue Bao Yi Xue Ban 2016; 47:371-375. [PMID: 27468483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To investigate the clinical outcome of immediate inguinal lymph node dissection on the survival of the patients with penile carcinoma. METHODS A total of 67 patients of penile carcinoma whose inguinal lymph nodes (ILN) were initial clinically impalpable, received inguinal lymph node dissection (ILND) from Dec 2008 to April 2014. Among them, 33 patients received immediate ILND within 1 month after the resection of penile cancer, while 34 patients underwent delayed ILND which was performed when ILN was found clinically apparent during follow-up. The Kaplan-Meier survival analysis was performed. The prognostic factors was evaluated by log-rank test, including age, morphology, location, T stage, grade of primary tumor, clinical status of ILN before ILND, lymphatic pathology, time to ILND. Cox proportional hazard model was used to find the independent risk factors on survival. RESULTS The median age was 50 year-old (range 26 to 84 year-old). The median follow-up time was 23 months (range 3-76 months). The 3-year and 5-year overall survival were 70.1% and 65.4%, respectively, The 5-year survival rate in immediate ILND and delayed ILND group were 93.1%, and 33.7% respectively. Positive ILN metastasis was found in 7 patients from immediate ILND group but 26 patients from delayed ILND group that the prognostic factors included T stage, tumor grade, clinical status of inguinal lymph nodes before ILND, and lymphatic pathology. Cox model found the status of inguinal lymph nodes was independent prognostic factor for the survival. CONCLUSION Inguinal lymph node metastasis is the important prognostic indicator of the survival of penile cancer. Immediate ILND could improve survival for the patients with clinically impalpable lymph nodes.
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