Radical penectomy, a compromise for life: results from the PECAD study

Ghahhari, Jamil; Marchioni, Michele; Spiess, Philippe E.; Chipollini, Juan; Nyírády, Péter; Varga, Judith; Ditonno, Pasquale; Boccasile, Stefano; Primiceri, Giulia; Nunzio, Cosimo De; Tema, Giorgia; Tubaro, Andrea; Veccia, Alessandro; Antonelli, Alessandro; Musi, Gennaro; Cobelli, Ottavio De; Conti, Andrea; Puliatti, Stefano; Micali, Salvatore; Maestro, M. Álvarez; Olarte, J. Quesada; Diogenes, Erico; Lima, Marcos Venício Alves; Tracey, Andrew; Guruli, Georgi; Autorino, Riccardo; Sountoulides, Petros; Sosnowski, Roman; Schips, Luigi; Cindolo, Luca

doi:10.21037/tau.2020.04.04

Cited by 9 publications

(11 citation statements)

References 31 publications

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“…Penile granulomas and fibromas are rare cases of having a proper treatment [9]. In this case, the granuloma and fibromatosis in the patient developed into SCC which associated with chronic inflammation [10].…”

Section: Discussionmentioning

confidence: 91%

Total Penectomy and Perineal Urethrostomy Management of Penile Squamous Cell Carcinoma with Paraffinoma in Single Center Hospital: A Rare Case Report

Wibowo

Wijanarko

Ismail

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: Penile cancer is a rare condition, affecting less than 1% of the adult male population [1]. The risk of penile cancer increases significantly with age, poor hygiene, and the presence of the prepuce. The most common type encountered is squamous cell carcinoma (SCC). Clinically penile cancer appears as small lesions with induration and erythema or as large infiltrative ulcerative lesions. As the disease progresses, complaints such as itching, bleeding, discharge, foul odor, and pain occurred. CASE REPORT: A 63-year-old man with poor hygiene and has a history of diabetes mellitus had penis ulcers since 5 years ago. On physical examination, an ulcer with the size of 12 × 12 × 10 cm was found growing pus (-). Biopsy had done and confirmed SCC as a result. Pelvic multiple slice CT shows growth covering the entire shaft of the penis down to the base. The patient had a previous history of using silicone injection 35 years ago and causing Sclerofibromatosis. The patient was planned to undergo surgery with clinical diagnosis T4N0M0. Total penectomy was performed with an elliptical incision around the base with a margin of 2 cm. Sclerofibromatosis and the surrounding tissue were excised to the base of the penis followed by perineal urethrostomy. There was no problem postoperatively. The patient went home after staying in the hospital for 96 h. The surgical specimen revealed SCC with free of tumor excision margin. CONCLUSIONS: Injections with silicone to enlarge the penis cannot be justified. The process can trigger a chronic inflammatory reaction associated with penile malignancy. Total penectomy and wide excision with urethral perineostomy could be optimal initial treatment.

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Section: Discussionmentioning

confidence: 91%

Total Penectomy and Perineal Urethrostomy Management of Penile Squamous Cell Carcinoma with Paraffinoma in Single Center Hospital: A Rare Case Report

Wibowo

Wijanarko

Ismail

et al. 2021

Open Access Maced J Med Sci

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“…At the end of the follow-up, 57(22.9%) patients died from PSCC. The median number of LNR, PLNC, and lymph nodes examined was 0.04 (range of 0.00-1.00), 1(range of [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], and 17 (range of 2-78), respectively. A detailed description of the clinical-pathological characteristics of the enrolled patients is shown in Table 1.…”

Section: Patients' Characteristicsmentioning

confidence: 99%

The prognostic value of lymph node ratio in comparison to positive lymph node count in penile squamous cell carcinoma

Qian

Zhang

et al. 2021

Int Urol Nephrol

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Purpose Penile cancer is a rare male neoplasm with a wide variation in its global incidence. In this study, the prognostic value of lymph node ratio (LNR) was compared to that of positive lymph node count (PLNC) in penile squamous cell carcinoma. Methods A total of 249 patients with penile squamous cell carcinoma were enrolled from The Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. The X-tile program was used to calculate the optimal cut-off values of LNR and PLNC that discriminate survival. We used the χ2 or the Fisher exact probability test to assess the association between clinical-pathological characteristics and LNR or PLNC. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors for survival. Spearman correlation analysis was used to determine the correlation between LNR and PLNC. Results We found that patients with high LNR tended to have advanced N stage, the 7th AJCC stage, and higher pathological grade, while patients with high PLNC had advanced N stage and the 7th AJCC stage. Univariate Cox regression analysis revealed that the N stage, M stage, the 7th AJCC stage, lymph-vascular invasion, LNR, and PLNC were significantly associated with prognosis. Multivariate Cox regression analysis demonstrated that LNR rather than PLNC was an independent prognostic factor for cancer-specific survival. Subgroup analysis of node-positive patients showed that LNR was associated with CSS, while PLNC was not. Conclusion LNR was a better predictor for long-term prognosis than PLNC in patients with penile squamous cell carcinoma.

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“…As far a survival after RP is concerned, because it is mostly performed in patients with advanced-stage disease, more than 40% will die within the first 5 years, while 60% will relapse (4,20). This patient was no exception because he died one year after the surgery.…”

Section: Perineal Urethrostomy Stenosismentioning

confidence: 99%

“…Radical penectomy is infrequently performed and has precise indications which are increasingly the subject of controversy considering that meatal preservation is critical for quality of life (3). However, recent reports claim that RP is the main form of treatment in 15-20% of primary penile cancers (4).…”

Section: Introductionmentioning

confidence: 99%

Anesthetic considerations and postoperative pain management in radical penectomy: Case report

López

2021

Colomb. J. Anesthesiol.

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Radical penectomy (RP) is infrequently performed as it is reserved for specific cases of penile cancer, hence the paucity of reports regarding surgical and anesthetic considerations. Acute postoperative pain, chronic post-surgical pain, concomitant mood disorders as well as a profound impact on the patient’s quality of life have been documented. This case is of a patient with diabetes and coronary heart disease, who presented with advanced, overinfected penile cancer, depressive disorder and a history of pain of neuropathic characteristics. The patient underwent radical penectomy using a combined spinal-epidural technique for anesthesia. Preoperatively, the patient was treated with pregabalin and magnesium sulphate, and later received a blood transfusion due to intraoperative blood loss. Adequate intra and postoperative analgesia was achieved with L-bupivacaine given through a peridural catheter during one week. Recovery was good, pain was stabilized to preoperative levels and the patient received pharmacological support and follow-up by psychiatry and the pain team.

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Radical penectomy, a compromise for life: results from the PECAD study

Cited by 9 publications

References 31 publications

Total Penectomy and Perineal Urethrostomy Management of Penile Squamous Cell Carcinoma with Paraffinoma in Single Center Hospital: A Rare Case Report

Total Penectomy and Perineal Urethrostomy Management of Penile Squamous Cell Carcinoma with Paraffinoma in Single Center Hospital: A Rare Case Report

The prognostic value of lymph node ratio in comparison to positive lymph node count in penile squamous cell carcinoma

Anesthetic considerations and postoperative pain management in radical penectomy: Case report

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