Management of carcinoma of the penis: Consensus statement from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

Richter, Suzanne; Ruether, J. Dean; Wood, Lori; Canil, Christina; Moretto, Patrícia; Venner, Peter; Gingerich, Joel Roger; Emmenegger, Urban; Eisen, Andrea; Zalewski, Paweł; Joshua, Anthony M.; Mukherjee, Som D.; Heng, Daniel Yick Chin; Czaykowski, Piotr; Soulières, Denis; Blais, N.; Rendon, Ricardo; Fleshner, Neil; Crook, Juanita; Sridhar, Srikala S.

doi:10.5489/cuaj.1794

Cited by 13 publications

(14 citation statements)

References 97 publications

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“…Penile cancer is a rare malignancy, especially in developed countries, in which the annual incidence is below 1 case per 100 000 men. This incidence represents less than 1% of malignancies in this gender; however, in certain Asian, African, and South American countries, the occurrence may represent up to 10% of cases (1). One of the countries with the highest incidence of penile cancer in the world is India, with rates up to 3.32 per 100 000 men in some regions.…”

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confidence: 98%

Incidence of penile cancer worldwide: systematic review and meta-analysis

Cardona¹,

García‐Perdomo²

2017

Rev Panam Salud Publica

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Review Suggested citationMontes Cardona CE, García-Perdomo HA. Incidence of penile cancer worldwide: systematic review and meta-analysis. Rev Panam Salud Publica. 2017;41:e117. doi: 10.26633/RPSP.2017.117. Penile cancer is a rare malignancy, especially in developed countries, in which the annual incidence is below 1 case per 100 000 men. This incidence represents less than 1% of malignancies in this gender; however, in certain Asian, African, and South American countries, the occurrence may represent up to 10% of cases (1). One of the countries with the highest incidence of penile cancer in the world is India, with rates up to 3.32 per 100 000 men in some regions. In contrast, rates among Jewish men born in Israel are reportedly very close to zero (2).Penile cancer typically affects older men, and its incidence rate consistently increases with age (3). The age group most commonly affected by penile cancer is between 50 and 70 years, with a mean age of 67 years in the United States of America (4), although the disease has also been observed in patients under 40 years (3). The vast majority of patients have an apparently localized disease at diagnosis, with high-risk characteristics for nodal involvement but without clinical evidence of such involvement. This suggests that the morbidity and mortality among these patients is underestimated (5).The risk factors associated with a greater likelihood of developing the disease, as well as the factors associated with higher incidence rates, are clearly known (6). Nevertheless, neither the global impact of penile cancer nor the variations according to different geographic areas or the changing trends in different time intervals are precisely known. The objective of this systematic review was to determine the incidence of penile cancer in the global population. METHODSWe conducted a meta-analysis of observational studies, following the Metaanalysis of Observational Studies in Epidemiology (MOOSE) (7) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) ABSTRACTObjective.

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confidence: 98%

Incidence of penile cancer worldwide: systematic review and meta-analysis

Cardona¹,

García‐Perdomo²

2017

Rev Panam Salud Publica

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“…Moreover, postoperative radiotherapy can be offered depending on the amount of residual disease after chemotherapy [25]. In the same perspective of improving surgical results, and therefore decreasing local recurrence, preoperative radiotherapy should be considered in the presence of lymph nodes greater than or equal to 4 cm without skin fixation [26].…”

Section: Standard Treatment Of Metastatic Penile Cancermentioning

confidence: 99%

Do Checkpoint Inhibitors Provide New Hope for Management Of Metastatic Penile Carcinoma?

et al. 2018

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Penile carcinomas are rare in the USA, Europe and other industrialized countries [1]. In contrast, their incidence is significantly higher in some less developed countries in South America, Africa and Asia, accounting for as much as 10-20% of male cancers [2,3]. The annual incidence of penile squamous cell carcinoma (SCC) increases with age, with a median age of 68 years [4,5]. Many factors are known to increase the risk of developing a precursor lesion or a SCC of the penis, such as phimosis, HPV, HIV and tobacco exposure [6][7][8][9]. A number of medical conditions are also associated with an increased risk of developing penile cancer: a history of penile injury, tear, or chronic rash lasting one month or longer; a history of urethral structure, urinary tract infection or genital warts [8]. It is interesting to note that sexual orientation (heterosexual, bisexual/homosexual) is not a risk factor for penile cancer [9].The majority of penile cancers are diagnosed at a local stage (61%); these cancers are characterized by early locoregional spread with subsequent potential for distant dissemination [10]. Disseminated metastatic penile cancers are treated based on the localizations of the metastases, the symptoms of the patients and their performance status [11]. In general, for the treatment of metastatic penile cancer, systemic chemotherapy, radiation therapy or chemoradiation can be considered [12]. Given the rarity of penile cancer, there are no randomized clinical trials to define the preferred chemotherapeutical regimen [13,14].With the tsunami of checkpoint inhibitors during the last 3 years, these potent anticancer agents showed remarkable results in the management of different malignancies. During the last few years, checkpoint inhibitors were approved in melanoma, non-small-cell lung cancer, bladder cancer, squamous cell head and neck cancer, renal cell carcinoma and Hodgkin's lymphoma. They were tested in rare cancers where no strong standard of care treatment was present [15].We aimed in this paper to first describe the standard treatment of metastatic penile cancer. Given the fact that checkpoint inhibitors are demonstrating promising results in different malignancies, we then focused on their potential role in the management of this rare disease based on histology, risk factors and ongoing trials results.The rationale behind the use of checkpoint inhibitors in metastatic penile cancers In the absence of highly efficient therapies in the treatment of metastatic penile carcinoma, this rare tumor seems to be an interesting landscape for exploring checkpoint inhibitors. Different histologic, epidemiologic and therapeutic aspects encouraged researchers to test this drug in this malignancy. In fact, checkpoint inhibitors showed interesting results in virus-induced cancer, namely those related to HPV in SCC of the head and neck, the cervix and the anus [16]. This is mainly attributed to a specific immunologic profile probably related to a higher mutational load of these tumors and a higher expression of PD-...

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“…Penile cancer (PC) is a rare disease, accounting for 0.4% to 0.6% of all malignant neoplasms among men in the United States and Europe. ( 1 , 2 ) However, it is well documented that the incidence of PC is higher in developing countries, and may account for as high as 10% to 20% of male urogenital tumors in these regions. ( 3 , 4 ) Although relatively rare, PC has a 5-year survival rate of approximately 50% (over 85% for patients with negative lymph nodes, and 29% and 40% with positive nodes), and many times results in devastating disfigurement.…”

Section: Introductionmentioning

confidence: 99%

“…O câncer de pênis (CP) é uma doença rara, que representa de 0,4% a 0,6% de todas as neoplasias malignas entre homens nos Estados Unidos e na Europa. ( 1 , 2 ) No entanto, está bem documentado que a incidência de CP é maior nos países desenvolvidos, podendo ser responsável por até 10% a 20% dos tumores urogenitais masculinos nessas regiões. ( 3 , 4 ) Embora relativamente raro, o CP tem taxa de sobrevida em 5 anos de cerca de 50% (mais de 85% para pacientes com linfonodos negativos, e de 29% a 40% quando positivos) e, muitas vezes, leva à desfiguração devastadora.…”

Section: Introductionunclassified

Penile cancer trends and economic burden in the Brazilian public health system

Korkes¹,

Rodrigues²,

Baccaglini³

et al. 2020

Einstein (São Paulo)

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Objective: To gather information on penile cancer epidemiologic trends and its economic impact on the Brazilian Public Health System across the last 25 years. Methods: The Brazilian Public Health System database was used as the primary source of data from January 1992 to December 2017. Mortality and incidence data from the Instituto Nacional de Câncer José Alencar Gomes da Silva was collected using the International Classification of Diseases ICD10 C60. Demographic data from the Brazilian population was obtained from the last census by the Brazilian Institute of Geography and Statistics, performed in 2010 and its 2017 review. Results: There were 9,743 hospital admissions related to penile cancer from 1992 to 2017. There was a reduction (36%) in the absolute number of admissions per year related to penile cancer in 2017, as compared to 1992 (2.7 versus 1.7 per 100,000; p<0.001). The expenses with admissions related to this condition in this period were US$ 3,002,705.73 (US$ 115,488.68/year). Approximately 38% of the total amount was spent in Northeast Region. In 1992, penile cancer costed US$ 193,502.05 to the public health system, while in 2017, it reduced to US$ 47,078.66 (p<0.02). Penile cancer incidence in 2017 was 0.43/100,000 male Brazilian, with the highest incidence rate found in the Northeast Region. From 1992 to 2017, the mortality rates of penile cancer in Brazil were 0.38/100,000 man, and 0.50/100,000 man in the North Region. Conclusion: Despite the decrease in admissions, penile cancer still imposes a significant economic and social burden to the Brazilian population and the Public Health System.

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Management of carcinoma of the penis: Consensus statement from the Canadian Association of Genitourinary Medical Oncologists (CAGMO)

Cited by 13 publications

References 97 publications

Incidence of penile cancer worldwide: systematic review and meta-analysis

Incidence of penile cancer worldwide: systematic review and meta-analysis

Do Checkpoint Inhibitors Provide New Hope for Management Of Metastatic Penile Carcinoma?

Penile cancer trends and economic burden in the Brazilian public health system

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