What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes

Sakalis, Vasileios; Campi, Riccardo; Barreto, Lenka; García‐Perdomo, Herney Andrés; Greco, I.; Zapała, Łukasz; Kailavasan, Mithun; Antunes-Lopes, Tiago; Marcus, Jack David; Manzie, Kenneth; Osborne, John; Ayres, Benjamin; Moonen, L.; Necchi, Andrea; Crook, Juanita; Oliveira, Pedro; Pagliaro, Lance C.; Protzel, Chris; Parnham, Arie; Albersen, Maarten; Pettaway, Curtis A.; Spiess, Philippe E.; Tagawa, Scott T.; Rumble, R. Bryan; Brouwer, O.R.

doi:10.1016/j.euros.2022.04.002

Cited by 9 publications

(2 citation statements)

References 104 publications

(600 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A paradigm shift in penile cancer treatment has occurred with an increase in use of penile-sparing approaches and decreasing rates of penile amputation. 1-5 Penile organ-sparing surgery (OSS) includes topical and laser therapy, wide local excision (WLE), glansectomy, and Mohs micrographic surgery (Mohs). Currently, the National Comprehensive Cancer Network (NCCN) Version 1.2023 penile cancer guidelines state Tis, Ta, and T1 penile cancer may be amenable to conservative penile organ-sparing approaches, 6 citing evidence that overall survival rates are comparable for patients with T1-T2 tumors treated with OSS compared to partial or total penectomy.…”

mentioning

confidence: 99%

Total Margin Control Is Superior to Traditional Margin Assessment for Treatment of Low-Stage Penile Squamous Cell Carcinoma

O’Connell,

Thomas,

Murad

et al. 2024

Journal of Urology

View full text Add to dashboard Cite

Purpose:Penile cancer is rare, with significant morbidity and limited literature assessing utility of peripheral and deep en face margin assessment (PDEMA) vs traditional margin assessment (vertical sections) on treatment outcomes.Materials and Methods:This was a 32-year retrospective multicenter cohort study at 3 academic tertiary care centers. The cohort consisted of 189 patients with histologic diagnosis of in situ or T1a cutaneous squamous cell carcinoma of the penis at Brigham and Women’s, Massachusetts General Hospital (1988-2020), and Memorial Sloan Kettering Cancer Center (1995-2020) treated with PDEMA surgical excision, excision/circumcision, or penectomy/glansectomy. Local recurrence, metastasis, and disease-specific death were assessed via multivariable Cox proportional hazard models.Results:The cohort consisted of 189 patients. Median age at diagnosis was 62 years. Median tumor diameter was 1.3 cm. The following outcomes of interest occurred: 30 local recurrences, 13 metastases, and 5 disease-specific deaths. Primary tumors were excised with PDEMA (N = 30), excision/circumcision (N = 110), or penectomy/glansectomy (N = 49). Of patients treated with traditional margin assessment (non-PDEMA), 12% had narrow or positive margins. Five-year proportions were as follows with respect to local recurrence-free survival, metastasis-free survival, and disease-specific survival/progression-free survival, respectively: 100%, 100%, and 100% following PDEMA; 82%, 96%, and 99% following excision/circumcision; 83%, 91%, and 95% following penectomy/glansectomy. A limitation is that this multi-institutional cohort study was not externally validated.Conclusions:Initial results are encouraging that PDEMA surgical management effectively controls early-stage penile squamous cell carcinoma.

show abstract

mentioning

confidence: 99%

Total Margin Control Is Superior to Traditional Margin Assessment for Treatment of Low-Stage Penile Squamous Cell Carcinoma

O’Connell,

Thomas,

Murad

et al. 2024

Journal of Urology

View full text Add to dashboard Cite

show abstract

“…The higher risk of local recurrence associated with poorer survival [12] in comparison to partial or radical penectomy must be discussed with the patient in a well balanced decision-making process. American and European guidelines maintain a cautious attitude toward the use of OSS in T1-T2 PeCa, underlying a complete absence of both randomized controlled trials and prospective trials [13 ▪▪ ].…”

Section: Introductionmentioning

confidence: 99%

Organ-sparing treatment for T1 and T2 penile cancer: an updated literature review

Scornajenghi

Asero

Bologna

et al. 2023

Current Opinion in Urology

View full text Add to dashboard Cite

Purpose of reviewPenile cancer (PeCa) is an orphan disease due to its rare incidence in high-income countries. Traditional surgical options for clinical T1--2 disease, including partial and total penectomy, can dramatically affect patient's quality of life and mental health status. In selected patients, organ-sparing surgery (OSS) has the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of various OSSs currently available for men diagnosed with PeCa seeking an organ-preserving option. Recent findingsPatient survival largely depends on spotting and treating lymph node metastasis at an early stage. The required surgical and radiotherapy skill sets cannot be expected to be available in all centers. Consequently, patients should be referred to high-volume centers to receive the best available treatments for PeCa. SummaryOSS should be used for small and localized PeCa (T1-T2) as an alternative to partial penectomy to preserve patient's quality of life while maintaining sexual and urinary function and penile aesthetics. Overall, there are different techniques that can be used with different response and recurrence rates. In case of tumor recurrence, partial penectomy or radical penectomy is feasible, without impacting overall survival.

show abstract

Expertise Area 3.1: Penile cancer

Vreeburg,

Kirrander,

Falcone

et al. 2024

Rare and Complex Urology

View full text Add to dashboard Cite

What Is the Most Effective Management of the Primary Tumor in Men with Invasive Penile Cancer: A Systematic Review of the Available Treatment Options and Their Outcomes

Cited by 9 publications

References 104 publications

Total Margin Control Is Superior to Traditional Margin Assessment for Treatment of Low-Stage Penile Squamous Cell Carcinoma

Total Margin Control Is Superior to Traditional Margin Assessment for Treatment of Low-Stage Penile Squamous Cell Carcinoma

Organ-sparing treatment for T1 and T2 penile cancer: an updated literature review

Expertise Area 3.1: Penile cancer

Contact Info

Product

Resources

About