Conservative surgical therapy for penile and urethral carcinoma

Davis, John W.; Schellhammer, Paul F.; Schlossberg, Steven M.

doi:10.1016/s0090-4295(98)00483-x

Cited by 78 publications

(32 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…4,14,15 The occasional involvement of the urethra by precancerous lesions should be taken into consideration when planning conservative, glans-sparing surgical procedures for limited primary squamous cell penile cancer. 16 Often, in partial penectomies the surgeon leaves a long urethra to preserve urinary function increasing the risk of a positive margin of resection. Carcinoma in situ of urethral epithelium may be the only positive surgical margin of resection.…”

Section: Discussionmentioning

confidence: 99%

Epithelial abnormalities and precancerous lesions of anterior urethra in patients with penile carcinoma: a report of 89 cases

et al. 2005

View full text Add to dashboard Cite

Urethral and penile tissues and their neoplasms are considered anatomically and pathogenetically different. Since we observed urethral dysplastic lesions and some similarities between noninvasive and invasive lesions of the anterior urethra and glans, we designed this study to document epithelial urethral abnormalities in patients with penile squamous cell carcinoma. We examined urethral epithelia from 170 penectomies with invasive squamous cell carcinoma finding a variety of primary epithelial abnormalities in 89 cases (52%) and secondary invasion of penile carcinoma to urethra in 42 cases (25%). Patients' average age was 68 years. Primary tumors measured 4 cm in average diameter and the majority were squamous cell carcinoma of the usual (67%) or verrucous type (15%). Primary epithelial abnormalities found were squamous intraepithelial lesions, metaplasias and microglandular hyperplasias. Urethral squamous intraepithelial lesions of high grade was found in six patients and of low grade in eight cases. Squamous metaplasia, seen in 69 cases, was the most frequent finding. Metaplasias were classified as nonkeratinizing and keratinizing. Nonkeratinizing metaplasias (57 cases) were variegated in morphology: simplex (26 cases), hyperplastic (12 cases), clear cell (11 cases) and spindle (8 cases). Keratinizing metaplasias (12 cases) showed hyperkeratosis and were more frequently associated with verrucous than nonverrucous penile squamous cell carcinoma. Microglandular hyperplasia was present in eight cases. Lichen sclerosus was associated with simplex squamous metaplasia in four cases. Despite the large size of the primary tumors, direct urethral invasion by penile carcinoma was present in only 25% of the cases. The presence of precancerous lesions in urethra of patients with penile carcinoma indicates urethral participation in the pathogenesis of penile cancer. Simplex squamous metaplasia is a common finding probably related to chronic inflammation. Keratinizing and hyperplastic squamous metaplasias may be important in the pathogenesis of special types of penile carcinomas such as verrucous carcinoma. Modern Pathology (2005) 18, 917-923.

show abstract

Section: Discussionmentioning

confidence: 99%

Epithelial abnormalities and precancerous lesions of anterior urethra in patients with penile carcinoma: a report of 89 cases

et al. 2005

View full text Add to dashboard Cite

show abstract

“…5,9,10-12 Indeed, many reports have shown similar 5-year disease-specific survival rates, reducing the width of the resection margins to 10 and 15 mm for grade 1-2 and 3 lesions, respectively. 9,11,13,14 If tumor recurrence occurs, it is usually systemic at the inguinal lymph nodes. In our series of patients treated with total glansectomy, only one patient had inguinal lymph node metastases 18 months after surgery, whereas none had local relapse, and our crude disease-specific survival rate of 93.3% after a mean follow-up of 36 months is similar to that reported by others using conventional surgical treatment.…”

Section: Figurementioning

confidence: 99%

Glansectomy with split-thickness skin graft for the treatment of penile carcinoma

et al. 2009

View full text Add to dashboard Cite

Using our prospectively derived database, we identified 17 patients with squamous-cell carcinoma involving the glans penis, who were treated using organ-sparing surgery between March 2003 and January 2008. Of them, two were treated with partial glansectomy with primary glans closure, and 15 underwent total glans amputation and reconstruction of a new glans using a split-thickness skin graft (STSG). These 15 patients represent the subject of our study (mean age 51 years, range 42 to 59 years). Overall, two patients had early partial loss of the graft and of them, one required surgical regrafting. Two late complications occurred, consisting of one meatal stenosis and one postoperative phimosis. At a mean follow-up of 36 months, functional results were extremely satisfactory. All patients maintained their erectile function with good vaginal penetration starting from 3 months after surgery, with a range between 2 and 6 months. Orgasm and ejaculation were preserved in all patients, although reduced glans sensitivity was reported by all patients. No local recurrences were reported.

show abstract

“…They concluded that local disease recurrence rates were lower with the latter treatment (5.3 vs. 27.7%) but there was no significant difference in overall disease survival [43]. Also, patients undergoing penile-preserving therapy (pN+), and those undergoing a wait-and-see policy for the nodal status are at high risk of developing a recurrence [44][45][46][47][48].…”

Section: Partial Penectomymentioning

confidence: 99%

Organ Preservation Surgery for Carcinoma Penis

Yuvaraja

Waigankar

Dharmadhikari

et al. 2016

Indian J Surg Oncol

View full text Add to dashboard Cite

Carcinoma of the penis is not uncommon in India. A sizeable number of patients do not report to the doctors in fear of mutilation to the organ and hence subsequently end up with advanced disease. Many patients with T1 or T2 disease when carefully selected are amenable to organ-preserving penile procedures including surgery, topical therapy, laser, and radiation therapy. Identification of appropriate patients and institution of these treatments has been noted to produce oncologically comparable results to extirpative surgeries. In this article, we review the criteria to identify patients qualifying for organ-preserving treatments and also review outcomes with a variety of penile-preserving procedures.

show abstract

Conservative surgical therapy for penile and urethral carcinoma

Cited by 78 publications

References 29 publications

Epithelial abnormalities and precancerous lesions of anterior urethra in patients with penile carcinoma: a report of 89 cases

Epithelial abnormalities and precancerous lesions of anterior urethra in patients with penile carcinoma: a report of 89 cases

Glansectomy with split-thickness skin graft for the treatment of penile carcinoma

Organ Preservation Surgery for Carcinoma Penis

Contact Info

Product

Resources

About