Clinicopathologic Characteristics and Outcomes of Penile Cancer Treated at Tertiary Care Centers in the Western United States

Jayaratna, Isuru; Mitra, Anirban P.; Schwartz, Richard S.; Dorff, Tanya B.; Schuckman, Anne

doi:10.1016/j.clgc.2013.09.006

Cited by 17 publications

(18 citation statements)

References 21 publications

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“…Several risk factors for lymph node metastases have been identified, particularly high grade and T2 disease,2627 and a positive inguinal lymph node is a significant negative prognosticator of survival in patients with PSCC 28. Consistent with a previous report, the present study identified correlations of an AJCC disease stage ≥ stage III (≥ pT1-3pN1cM0) with an unfavorable CSS and RFS 14. Therefore, our study re-confirmed the significant association of the lymph node status with survival.…”

Section: Discussionsupporting

confidence: 92%

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Prognostic Factors of Penile Cancer and the Efficacy of Adjuvant Treatment after Penectomy: Results from a Multi-institution Study

Kim

et al. 2018

J Korean Med Sci

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BackgroundPenile cancer is a rare malignancy associated with high rates of mortality and morbidity. Currently, the efficacy of adjuvant treatment (AT), including radiotherapy and chemotherapy, for penile cancer remains unclear. Therefore, we investigated the prognostic factors for treatment outcomes and the efficacy of AT in consecutive patients who underwent penectomy for penile cancer at multiple Korean institutions between 1999 and 2013.MethodsAT was defined as the administration of chemotherapy, radiotherapy, or both within 12 months after initial treatment. All patients were divided into two groups according to the AT status.ResultsForty-three patients (median age 67.0 years) with a median follow-up after penectomy of 26.4 (interquartile range: 12.0–62.8) months were enrolled. Patients with AT had a significantly higher pathologic stage. However, no differences in age, histologic grade, or type of surgery were identified according to the presence of AT. The 3- and 5-year cancer-specific survival (CSS) rates were 79.0% and 33.0%, respectively. In a multivariate analysis, American Joint Committee on Cancer (AJCC) stage ≥ III disease was an independent predictor of CSS and recurrence-free survival (RFS). However, AT was not associated with CSS and RFS. The type of primary surgical treatment and inguinal lymph node dissection at diagnosis were also not significantly associated with overall survival, CSS, or RFS.ConclusionAJCC stage ≥ III disease, which mainly reflects lymph node positivity, is a significant prognosticator in patients with penile cancer. By contrast, AT does not seem to affect CSS and RFS.

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Section: Discussionsupporting

confidence: 92%

“…The incidence of PSCC tends to increase markedly during the sixth decade of life 1314. A recent study found that the median age of patients with penile cancer in Los Angeles is younger than ages reported elsewhere in the US 1516.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Penile Cancer and the Efficacy of Adjuvant Treatment after Penectomy: Results from a Multi-institution Study

Kim

et al. 2018

J Korean Med Sci

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“…The number of patients with characteristics of advanced disease, like lymph node enlargement on admission (41.8%), high histological grade (87%), and T stage ≥2 (82%) was high. These are higher than those in other Brazilian studies 10,20 and studies in developed nations such as Finland 44 and the USA 45 . Although histological subtypes related to HPV represented the major part of the sample, there was no significant relationship with high grade (p = 0.16) or advanced stage (p = 0.63).…”

Section: Discussioncontrasting

confidence: 59%

Profile of patients with penile cancer in the region with the highest worldwide incidence

Vieira

Feitoza

Pinho

et al. 2020

Sci Rep

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To determine the epidemiological, histopathological, and clinical characteristics of patients diagnosed with penile cancer in the Brazilian state of Maranhão, the region with the highest incidence worldwide. One hundred and sixteen penile cancer patients were interviewed from July 2016 to October 2018. The majority of patients lived in a rural area (57%), worked in farming (58%), had a low level of schooling or no schooling (90%), and were married or in a stable relationship (74%). The mean age was 60.4 ± 16.51 years (range, 23-93 years). Phimosis (66%), poor/moderate genital hygiene (73%), history of sexually transmitted infections (55%), and zoophilia (60%) were found in the majority of patients. Most patients had their first sexual encounter at 16.2 ± 2.8 years (range, 10-25 years), and 75% had >6 sexual partners. The most common initial symptom was pruritus (37%), and most patients waited to seek treatment (average time to treatment, 18.9 months; range, 2-84 months). Human papillomavirus (HPV)-related histologies were observed in 62% of patients. Most patients had histological grades II or III (87%), stage ≥T2 disease (84%), and lymphadenopathy at admission (42%). Penectomy was performed in 96% of patients. The population with penile cancer in the region of highest incidence in the world is marked by low socioeconomic status, high prevalence of HPV infection, and phimosis. The delay in seeking treatment is related to a very high rate of advanced cancer and aggressive surgical treatment. The high prevalence of young patients was also a striking feature.Penile cancer is uncommon in developed countries, and its incidence varies according to the demographic region and the circumcision status 1,2 . In the US and Europe, the age-standardized incidence rate (ASR) for 100,000 inhabitants is between 0.1 and 1.0 3 . However, in less developed countries, including some countries in South America, Asia, and Africa, the incidence is alarmingly high 1 . In uncircumcised males, the cumulative lifetime risk for cancer of the penis is higher compared to the general population, corresponding to 1 in 600 men in the US 2 . Brazil has a high incidence, and the state of Maranhão, located in the northeastern region of the country, has the highest incidence of penile cancer in the world (ASR of 6.1 cases per 100,000 inhabitants) 4 .The etiology of penile carcinoma remains unknown, and its mechanisms of development have not been completely elucidated. Phimosis, balanitis, smegma, precarious genital hygiene, smoking, history of sexually transmitted infections (STIs), and human papilloma virus (HPV) infection (present in approximately 50% of cases) are the main risk factors, and circumcision is an important protective factor 5-8 . Its incidence is higher in regions History of STIs 55 (40/73) Sexual history Age of first sexual encounter [mean (range)] 16.2 years (10-25 years) Zoophilia 60 (43/72) No. female partners Less than 6 25 (19/75) Between 6 and 10 17 (13/75) More than 10 58 (43/75) Duration of symptom [mean (range)] 18.9 months ...

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“…A Brazilian study followed up 648 patients for a median period of 11 months and observed higher CSS in 10 years among those with well differentiated tumors when compared to those with moderate differentiation or undifferentiated regardless surgical specific treatment (log rank p<0.0001 and p=0.006 respectively) (19). Different rates of 5 year-GS were observed according to tumor differentiation grade in a series of 89 patients with a median follow-up of 23 months (24). Patients with high grade tumor had lower GS in 5 years than those with moderately differentiation or low grade (53% and 29% respectively; p=0.01).…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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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.

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Clinicopathologic Characteristics and Outcomes of Penile Cancer Treated at Tertiary Care Centers in the Western United States

Cited by 17 publications

References 21 publications

Prognostic Factors of Penile Cancer and the Efficacy of Adjuvant Treatment after Penectomy: Results from a Multi-institution Study

Prognostic Factors of Penile Cancer and the Efficacy of Adjuvant Treatment after Penectomy: Results from a Multi-institution Study

Profile of patients with penile cancer in the region with the highest worldwide incidence

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

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