Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy

Abstract

Introduction:The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. Physical exam and image exams are not adequate to evaluate inguinal lymph nodes and many patients are submitted to non-therapeutic lymphadenectomies. However, it is known that not all patients with clinically or histologically negative inguinal lymph nodes evolve favorably.Casuistic and Methods:the authors evaluated the clinical and pathologic characteristics of 163 patients with penile carcinoma and clinically negative inguinal lymph nodes followed for three or more years and their impact on global survival (GS) and cancer-specific survival (CSS) in the 10-year follow-up. Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019).Conclusion:high histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years.

Molecular carcinogenesis in equine penile cancer: A potential animal model for human penile cancer

“…In the latter group a twotier grading system of the IF identified 14 well-differentiated and 20 poorlydifferentiated ePSCC. The histological appearance of ePP resembles the human 'differentiated' and 'warty' subtypes of penile intraepithelial neoplasia (PeIN) and ePSCC is virtually identical to the most common subtype of PSCC termed 'usual type' [4,26]. The new WHO classification for epithelial penile tumors is based on both morphological features and immunoreactivity of the biopsy sample for p16 HPV [5,26].…”

“…In contrast, it is more common in developing countries accounting for up to 10-17% of cancer in males with an incidence that reaches 4 per 100,000 [1,2]. Squamous cell carcinoma (SCC) is the predominant cancer type and accounts for over 95% of penile cancer cases [3][4][5]. The main treatment for advanced tumors is phalectomy and, when inguinal lymph node metastasis is present, bilateral inguinal lymphadenectomy is also performed.…”

“…The main treatment for advanced tumors is phalectomy and, when inguinal lymph node metastasis is present, bilateral inguinal lymphadenectomy is also performed. These procedures are associated with high psychological morbidity and negatively impact the quality of life of affected patients [4]. In the UK, it is reported that there has been an increase in incidence of approximately 25% since 1985 [6,7].…”

Comparison of efficacy between brachytherapy and penectomy in patients with penile cancer: a meta-analysis

“…However, there were no significantly difference in five-year survival rate between two groups. Tumor grade [ 34 ], lymph nodes positive, and regional lymph node metastasis were associated with survival status [ 35 ]. Therefore, keeping the penile was required for patients’ life quality.…”

Prognostic Nomogram for Penile Cancer, an Analysis Based on SEER Database

“…The recent guideline on PC from European Association of Urology strongly a rmed the importance of strict grade in pathological assessment [29]. Aita et al claimed that high histopathological grade was responsible for a poor prognosis based on a study with an average follow-up more than 3 years involving 163 PC patients [30]. Other studies also emphasized the importance of pathologic grade [31,32].…”