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Dabán-López P, Fernández-Martínez NF, Petrova D, Rodríguez-Barranco M, Jiménez-Moleón JJ, Gutierrez J, Sánchez MJ. Epidemiology of human papillomavirus-associated anogenital cancers in Granada: a three-decade population-based study. Front Public Health 2023; 11:1205170. [PMID: 37780447 PMCID: PMC10537955 DOI: 10.3389/fpubh.2023.1205170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction HPV infection is a common risk factor for all anogenital cancers. However, there are important differences in the epidemiology of anogenital cancers and these have not been compared considering diverse epidemiological indicators over a long period of time. To fill this gap, we investigated incidence, mortality, and survival trends of anogenital cancers over a period of three decades. Methods We conducted an observational registry-based study using data from the population-based cancer registry of Granada in southern Spain. We collected data on all incident cases of anogenital cancer (cervical, anal, penile, vulvar, and vaginal cancer) diagnosed between 1985 and 2017. We calculated crude and age-standardized incidence and mortality rates, and 1, 3, and 5-year overall and net survival. We further conducted time-trend analysis calculating annual percent changes (APC) for each cancer site. Results The incidence of anogenital cancers decreased slightly during the past 30 years, with the exception of vulvar cancer, where a slight increase was observed. Mortality decreased significantly for cervical cancer over the study period but increased non-significantly for the remaining cancer sites. Survival rates were similar to those reported in comparable countries and increased for cervical and vulvar cancer. Discussion Cervical cancer was the greatest contributor to the burden of anogenital cancers and showed a marked improvement in all indicators in comparison to the remaining cancer sites.
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Affiliation(s)
- Pablo Dabán-López
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Cecilio, Granada, Spain
| | - Nicolás Francisco Fernández-Martínez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Miguel Rodríguez-Barranco
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Jose Juan Jiménez-Moleón
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
| | - Javier Gutierrez
- Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitario San Cecilio, Granada, Spain
| | - María-José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain
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Ulvskog E, Drevin L, Persson EK, Lambe M, Kirrander P, Ahlgren J. Oncological therapy to Swedish men with metastatic penile cancer 2000-2015. Acta Oncol 2021; 60:42-49. [PMID: 33030399 DOI: 10.1080/0284186x.2020.1829039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Penile cancer is an uncommon disease with poor prognosis when spread to more than one inguinal lymph node. Recommendations on chemo- and radiotherapy in treatment guidelines are based on low-grade evidence. There are to our knowledge no described population-based cohort with detailed information on given oncological treatment and survival data. The aim of this study is to investigate in detail how men with metastatic penile cancer have been treated with chemotherapy and radiotherapy over time, and how survival varies with N-stage and given treatment. MATERIAL AND METHODS For this observational cohort study all men in Sweden diagnosed with penile cancer with lymph node- or distant metastases 2000-2015 were identified through the Swedish National Penile Cancer Register (NPECR). Medical records were retrieved and 325 men were confirmed to have metastatic penile cancer (Tany, c or pN1-3 and/or M1). Information on treatments was collected. Causes of death were retrieved from the National Cause of Death Register (CDR). RESULTS Chemotherapy and/or radiotherapy were given to 172 (53%) of all men. The use of oncological treatments with curative intent increased significantly during the study period, from 30% of men with c/pN2-3 diagnosed 2000-2003 compared with 57% of men diagnosed 2012-2015. Ninety-three (29%) men received oncological treatments with curative intent of whom 85/93 (91%) had stage c/pN2-3M0. Survival decreased with higher N-stage, M1-stage, and absence of oncological treatment with curative intent. For men with c/pN3-stage, the engagement of pelvic lymph nodes was entailed with lower survival than pN3 based on extra-nodal extension (ENE). CONCLUSION The use of oncological treatment was below recommendations in guidelines but increased during the study period. Treatment was given predominantly to men with c/pN2-3 and M1-disease. Survival was higher among men treated with curative intent; this could be due to patient selection bias.
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Affiliation(s)
- Emma Ulvskog
- Faculty of Medicine and Health, Department of Oncology, Örebro University, Örebro, Sweden
| | - Linda Drevin
- Regional Cancer Centre, Uppsala-Örebro, Uppsala, Sweden
| | | | - Mats Lambe
- Regional Cancer Centre, Uppsala-Örebro, Uppsala, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Kirrander
- Faculty of Medicine and Health, Department of Urology, Örebro University, Örebro, Sweden
| | - Johan Ahlgren
- Regional Cancer Centre, Uppsala-Örebro, Uppsala, Sweden
- Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Qi F, Wei X, Zheng Y, Ren X, Li X, Zhao E. Incidence trends and survival outcomes of penile squamous cell carcinoma: evidence from the Surveillance, Epidemiology and End Results population-based data. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1428. [PMID: 33313173 PMCID: PMC7723588 DOI: 10.21037/atm-20-1802] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background To provide the latest incidence trends and explore survival outcomes of penile squamous cell carcinoma (PSCC) patients with or without a previous primary malignancy. Methods Patients diagnosed with PSCC between 1975 and 2016 in the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively included. Then, we calculated the age-adjusted incidence rates (IRs) and annual percentage changes (APCs). Multivariate Cox analysis and Kaplan-Meier (KM) survival curves were conducted to investigate prognostic variables for cancer-specific survival (CSS). Results A total of 6,122 PSCC patients were enrolled, 1,137 of whom had a prior malignancy. The age-adjusted IR for the general population in men declined before 1987, fluctuated slightly between 1987 and 1997, and showed an upward trend after 1997, which was basically consistent with that in patients without a previous primary malignancy. The incidence trend of PSCC in the general population was similar with that in those without a previous malignancy. However, the IRs of PSCC in men with a previous malignancy have been increasing since 1975 regardless of race. Furthermore, age at diagnosis, pathological grade, extent of disease, marital status, the administration of surgery and presence of previous primary malignancy were identified to be significantly related to CSS. Conclusions The IRs of PSCC have been increasing in recent years. Several independent prognostic factors for CSS were identified, allowing surgeons to assess the individualized risk in advance.
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Affiliation(s)
- Feng Qi
- Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiyi Wei
- First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Yuxiao Zheng
- Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Xiaohan Ren
- First Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Xiao Li
- Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Erkang Zhao
- Department of Urology, Donghai County Hospital of Traditional Chinese Medicine, Lianyungang, China
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Lagacé F, Ghazawi FM, Le M, Savin E, Zubarev A, Powell M, Moreau L, Sasseville D, Popa I, Litvinov IV. Penile Invasive Squamous Cell Carcinoma: Analysis of Incidence, Mortality Trends, and Geographic Distribution in Canada. J Cutan Med Surg 2019; 24:124-128. [PMID: 31722549 DOI: 10.1177/1203475419888869] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Penile invasive squamous cell carcinoma (SCC) is a rare disease with several known risk factors. However, few studies have assessed its incidence, mortality, and temporal trends. OBJECTIVE Our objectives are to analyze the epidemiology of penile SCC in Canada and to examine patient distribution with this cancer across Canada in order to elucidate population risk factors. METHODS Three independent cancer registries were used to retrospectively analyze demographic data from Canadian men diagnosed with penile invasive SCC between 1992 and 2010. The Canadian Census of Population was used to calculate incidence and mortality rates at the province and Forward Sortation Area levels. RESULTS The overall age-adjusted incidence rate was 6.08 cases per million males. Four provinces with statistically significantly higher incidence rates were identified. The national crude incidence rates increased linearly between 1992 and 2010, whereas the age-adjusted incidence rates showed no significant increase during this time period. The overall age-adjusted mortality rate was 1.88 deaths per million males per year. The province of Saskatchewan had significantly higher mortality rates. There was no increase in crude or age-adjusted mortality rates between 1992 and 2010. There was a significant positive correlation between incidence rates and obesity, Caucasian ethnicity, and lower socioeconomic status. CONCLUSION This study was able to establish geographic variation for this malignancy at the provincial level. Although there are many established risk factors for penile SCC, our results suggest that the increase in crude incidence rates observed is largely due to the aging population.
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Affiliation(s)
- François Lagacé
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | | | - Michelle Le
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Evgeny Savin
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Andrei Zubarev
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Mathieu Powell
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Linda Moreau
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Denis Sasseville
- Division of Dermatology, McGill University, Montreal, QC, Canada
| | - Ioana Popa
- Division of Urological Surgery, Université de Montréal, QC, Canada
| | - Ivan V Litvinov
- Division of Dermatology, McGill University, Montreal, QC, Canada
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Johnstone PAS, Boulware D, Djajadiningrat R, Ottenhof S, Necchi A, Catanzaro M, Ye D, Zhu Y, Nicolai N, Horenblas S, Spiess PE. Primary Penile Cancer: The Role of Adjuvant Radiation Therapy in the Management of Extranodal Extension in Lymph Nodes. Eur Urol Focus 2018; 5:737-741. [PMID: 30327282 DOI: 10.1016/j.euf.2018.10.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/25/2018] [Accepted: 10/08/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND In head and neck cancer, the presence of extranodal extension (ENE) in lymph nodes (LNs) has been shown prospectively to require adding chemotherapy to postoperative radiation therapy (RT). Limited data exist regarding ENE in LNs from primary penile cancer (PeCa). OBJECTIVE To determine the association of RT and ENE in PeCa. DESIGN, SETTING, AND PARTICIPANTS We retrospectively analyzed the outcomes of 93 patients with pT1-4 N3 M0 (American Joint Committee on Cancer 7th edition) squamous cell carcinoma of the penis across four international centers. INTERVENTION If the inguinal nodal specimen had ENE or two or more positive inguinal LNs, RT was delivered to an ipsilateral inguinal field. An ipsilateral pelvic field was added for positive pelvic LNs on dissection. The delivered dose was usually 50Gy in 25 daily fractions. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Clinical and demographic characteristics of relapse-free (RFS), disease-specific (DSS), and overall (OS) survival were compared by ENE status and receipt of adjuvant RT. RESULTS AND LIMITATIONS Seventy-two percent of patients had inguinal ENE, and 49% had pelvic ENE. On multivariable analysis (MVA) of ENE-negative patients, an OS benefit was noted with postoperative chemotherapy (p=0.038) and inguinopelvic RT (p=0.037). RFS suffered with worsening grade of the lesion (moderately: p=0.027; poorly: p=0.038), but was improved with groin (p=0.016) and inguinopelvic (p=0.006) RT. On MVA of patients with ENE, inguinopelvic RT was associated with better DSS (p=0.041). Grade impacted DSS (moderately: p=0.043; poorly: p=0.033), and poorly differentiated lesions impacted RFS (p=0.013). CONCLUSIONS Inguinopelvic RT may benefit regional control in PeCa patients with positive pelvic LNs, but this appears to be limited to those without ENE. PATIENT SUMMARY For patients with penile cancer and positive pelvic lymph nodes, postoperative radiation therapy was found to decrease the likelihood of disease recurrence in the groin or pelvis only if extranodal extension was absent.
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Affiliation(s)
| | - David Boulware
- Department of Bioinformatics and Biostatistics, Moffitt Cancer Center, Tampa FL, USA
| | - Rosa Djajadiningrat
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Sarah Ottenhof
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Andrea Necchi
- Department of Urology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Mario Catanzaro
- Department of Urology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Dingwei Ye
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yao Zhu
- Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Nicola Nicolai
- Department of Urology, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy
| | - Simon Horenblas
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
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