Evaluation of Current TNM Classification of Penile Carcinoma

Leijte, Joost A.P.; Gallee, M.P.W.; Antonini, Ninja; Horenblas, Simon

doi:10.1016/j.juro.2008.05.011

Cited by 116 publications

(70 citation statements)

References 16 publications

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“…The survival rate significantly decreased when there were 4 or more metastatic nodes. In a large cohort of 513 penile cancer patients, Leijte, et al performed exploratory analysis to find optimal cutoff to better discriminate patients into a good and a poor risk groups 20 [ ] Lymphatic mapping study showed that bilateral inguinal drainage was observed in 89% of penile cancer patients . They failed to find a significant survival difference between 1 vs. 2 or greater tumor positive inguinal nodes and 1 or 2 vs. 3 or greater positive inguinal nodes (P=0.629 and 0.209, respectively).…”

Section: Number Of Metastatic Lymph Nodesmentioning

confidence: 99%

Lymph node metastases and prognosis in penile cancer

Zhu

2012

Chin. J. Cancer Res.

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Lymph node status is a key prognostic factor in penile squamous cell carcinoma. Recently, growing evidence indicates a multimodality approach consisting of neoadjuvant chemotherapy followed by consolidation surgery improves the outcome of locally advanced penile cancer. Thus, accurate estimation of survival probability in node-positive penile cancer is critical for treatment decision making, counseling of patients and follow-up scheduling. This article reviewed evolving developments in assessing the risk for cancer progression based on lymph node related variables, such as the number of metastatic lymph nodes, bilateral lymph node metastases, the ratio of positive lymph nodes, extracapsular extension of metastatic lymph nodes, pelvic lymph node metastases, metastatic deposit in sentinel lymph nodes and N stage in TNM classification. Controversial issues surrounding the prognostic value of these nodal related predictors were also discussed.

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Section: Number Of Metastatic Lymph Nodesmentioning

confidence: 99%

Lymph node metastases and prognosis in penile cancer

Zhu

2012

Chin. J. Cancer Res.

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“…The 2002 TNM classification for the staging of tumors of the penis has been criticized by several authors (17,(29)(30)(31). Because it is essentially a pathological assessment it is virtually impossible to clinically determine the precise level of tumor invasion and the real lymph node status.…”

Section: Figure 4 -In This Case No Linear Correlation Was Found Usingmentioning

confidence: 99%

Epidemiological aspects of penile cancer in Rio de Janeiro: evaluation of 230 cases

Koifman

Vides²,

Koifman

et al. 2011

Int. braz j urol.

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Purpose: To determine epidemiological characteristics of penile cancer in Rio de Janeiro, its associated risk factors and clinical manifestations. Patients and Methods: Between 2002 and 2008 we evaluated 230 patients at three public institutions, considering age, ethnicity, birthplace, marital status, educational level, religion, tobacco smoking, presence of phimosis and practice of circumcision. Results: The ages ranged from 25 to 98 years, with an average of 58.35 years. Of the 230 patients, 167 (72.7%) were from the southeast region of Brazil (which includes Rio de Janeiro) and 45 (19.5%) were from the northeast of the country. Most patients were white (67.3%), married (58.6%), smokers (56.5%) and had not completed primary school (71.3%). The predominant religion was Catholic (74.8%). Of the 46 (20%) circumcised patients, only 1 (2.2%) had undergone neonatal circumcision. Grade I tumors were present in 87 (37.8%) of the patients, grade II in 131 (56.9%) and grade III in 12 (5.3%). Lymphovascular embolization was observed in 63 (27.3%) and koilocytosis in 124 (53.9%) patients. Of the total, 41.3% had corpora cavernosa or corpus spongiosum infiltration, and 40 (17.4%) had urethral invasion. Prophylactic lymphadenectomy was performed on 56 (36.1%), therapeutic lymphadenectomy on 84 (54.2%) and hygienic lymphadenectomy for advanced disease on 15 (9.7%) patients. The median time between the lesion onset and clinical diagnosis was 13.2 months. The mean follow up was 28.8 months. Conclusion: Most of our patients were born in this state and had low socioeconomic status. Most of them were white men, married, smokers, uncircumcised, of the Catholic faith and in their sixties or older. Their disease was in most cases diagnosed only in the advanced stages.

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“…Not only is the distinction between T1 and T2 disease therefore more difficult, but the finding of T2 disease in the glans has different implications for the same stage in the shaft, with glansectomy (partial or complete) the treatment of choice [14,15] as opposed to partial or complete penectomy (and a significantly worse prognosis) in T2 disease involving the corpora cavernosa in the shaft [16]. The T3 classification is also problematic: involvement of the urethra is commonly near the meatus and may have a better prognosis than T2 involvement of the corpus spongiosum in the shaft [17]. These issues have led to the proposal of a new staging system more closely related to prognosis, also shown in Table 1 [18].…”

Section: Mri For Penile Cancermentioning

confidence: 99%

MRI of the penis

Kirkham¹

2012

The British Journal of Radiology

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ABSTRACT. MRI of the penis is an expensive test that is not always superior to clinical examination or ultrasound. However, it shows many of the important structures, and in particular the combination of tumescence from intracavernosal alprostadil, and highresolution T 2 sequences show the glans, corpora and the tunica albuginea well. In this paper we summarise the radiological anatomy and discuss the indications for MRI. For penile cancer, it may be useful in cases where the local stage is not apparent clinically. In priapism, it is an emerging technique for assessing corporal viability, and in fracture it can in most cases make the diagnosis and locate the injury. In some cases of penile fibrosis and Peyronie's disease, it may aid surgical planning, and in complex pelvic fracture may replace or augment conventional urethrography. It is an excellent investigation for the malfunctioning penile prosthesis.

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Evaluation of Current TNM Classification of Penile Carcinoma

Abstract: The current TNM classification for penile carcinoma does not adequately differentiate in terms of survival among several T and N categories. With some modifications prognostic stratification improves and clinical staging is facilitated.

Cited by 116 publications

References 16 publications

Lymph node metastases and prognosis in penile cancer

Lymph node metastases and prognosis in penile cancer

Epidemiological aspects of penile cancer in Rio de Janeiro: evaluation of 230 cases

MRI of the penis

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