1
|
Muneer A, Bandini M, Compérat E, De Meerleer G, Fizazi K, Gietema J, Gillessen S, Kirkham A, Sangar V, Alifrangis C, Powles T. Penile cancer: ESMO-EURACAN Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2024; 9:103481. [PMID: 39089768 PMCID: PMC11360427 DOI: 10.1016/j.esmoop.2024.103481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 08/04/2024] Open
Abstract
•This ESMO CPG provides recommendations for diagnosis, staging, pathology, treatment and follow-up of penile cancer. •Algorithms for the management of primary penile tumours and inguinal lymph nodes are provided. •The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe. •Recommendations are based on available scientific data and the authors’ collective expert opinion. •In clinical practice, all recommendations provided need to be discussed with patients in a shared decision-making approach.
Collapse
Affiliation(s)
- A Muneer
- Department of Urology and NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London; Division of Surgery and Interventional Science, University College London, UK
| | - M Bandini
- Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy
| | - E Compérat
- Department of Pathology, Medical University Vienna, Austria
| | - G De Meerleer
- Department of Radiation Oncology, University Hospitals Leuven, Leuven, Belgium
| | - K Fizazi
- Department of Cancer Medicine, Institut Gustave Roussy, University of Paris Saclay, Villejuif, France
| | - J Gietema
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - S Gillessen
- Oncology Institute of Southern Switzerland (IOSI), Ente Ospedaliero Cantonale (EOC), Bellinzona; Universita della Svizzera Italiana, Lugano, Switzerland
| | - A Kirkham
- Department of Radiology, University College London Hospitals NHS Foundation Trust, London
| | - V Sangar
- Department of Urology, The Christie NHS Foundation Trust, Manchester
| | - C Alifrangis
- Department of Oncology and NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London
| | - T Powles
- Barts Experimental Cancer Medicine Centre, Barts Cancer Institute, Queen Mary University of London, London, UK
| |
Collapse
|
2
|
Thumma N, Pitla N, Gorantla V, du Plessis M. A comprehensive review of current knowledge on penile squamous cell carcinoma. Front Oncol 2024; 14:1375882. [PMID: 38841163 PMCID: PMC11150677 DOI: 10.3389/fonc.2024.1375882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
Neoplasm of the penis is relatively rare in most regions representing 0-2% of cancers worldwide. While the penis can be affected by sarcomas, basal cell carcinomas or even melanoma, Penile Squamous Cell Carcinoma (PSCC) represents approximately 95% of all penile neoplasms. Despite its rarity and most common presentation at later decades of life most individuals diagnosed with PSCC are faced with significant decrease in quality of life. The prevalence and incidence vary among different regions and populations, but a common trend is for diagnosis to occur late (stage 4). Underdeveloped countries are traditionally reported to have higher incidence rates; however, rates may vary significantly between urban and rural areas even in developed countries. Age adjusted rates are on the rise in some countries that used to have incidence rates of 1:100 000 or less. The list of associated risk factors is long and includes among others, lack of neonatal circumcision, poor genital hygiene, socioeconomic status, history of human papillomavirus (HPV) infection and penile intraepithelial neoplasia (PeIN). Many risk factors are widely debated among experts however HPV and PeIN are indisputable risk factors, and both also form part of the classification system for PSCC. Both conditions may have occurred in the past or be present at the time of diagnosis and identifying them plays a major role in management strategies. For such a rare condition PSCC can present in many different forms clinically making diagnosis no easy feat. Diagnosis of PSCC is done through clinical examination, including lymph node palpation, followed by a biopsy, which is essential for the classification. Lymph node involvement is a common finding at first presentation and investigation of spread to deep nodes is important and can be done with the aid of PET-CT. Treatment options for PSCC include surgery, chemotherapy, and radiation therapy. Surgical removal of the tumor is considered the most effective however can lead to severe decrease of quality of life. Chemotherapy is used in the case of fixed or bulky lymph nodes, where surgery is not indicated, and for distant metastasis. Radiation therapy is particularly effective in the case of HPV-positive PSCC.
Collapse
Affiliation(s)
| | | | | | - Maira du Plessis
- Department of Anatomical Sciences, School of Medicine, St George's University, True Blue, Grenada
| |
Collapse
|
3
|
Osama MA, Gaur K, Chatterjee P, Agarwal K, Jyoti D. Acantholytic Squamous Cell Carcinoma: a Diagnostic Pitfall on Cytology. Indian J Surg Oncol 2023; 14:963-967. [PMID: 38187856 PMCID: PMC10767014 DOI: 10.1007/s13193-023-01811-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 08/25/2023] [Indexed: 01/09/2024] Open
Abstract
Acantholytic squamous cell carcinoma is an infrequent subtype of squamous cell carcinoma. This tumour variant being rare in itself has been rarely described at the penile location, thus leading to a limitation on information of pathological and immunohistochemical findings and prognosis. Clinical observations indicate an aggressive biologic behaviour. The cytological features on fine-needle aspiration cytology samples have rarely been described in literature. It is imperative for pathologists to be aware of the cytological features so as to allow the distinction of this variant from conventional squamous carcinoma. Here, we explore an intriguing case of a metastatic tumour to inguinal lymph node with the primary lesion at the penis which constituted a diagnostic challenge on cytological examination.
Collapse
Affiliation(s)
- Md Ali Osama
- Department of Pathology, Lady Hardinge Medical College, New Delhi, 110001 India
| | - Kavita Gaur
- Department of Pathology, Lady Hardinge Medical College, New Delhi, 110001 India
| | - Priti Chatterjee
- Department of Pathology, Lady Hardinge Medical College, New Delhi, 110001 India
| | - Kiran Agarwal
- Department of Pathology, Lady Hardinge Medical College, New Delhi, 110001 India
| | - Divya Jyoti
- Department of Pathology, Lady Hardinge Medical College, New Delhi, 110001 India
| |
Collapse
|
4
|
Pang KH, Girling B, Osinibi E, Sawhney P, Haider A, Freeman A, Hadway P, Nigam R, Rees R, Mitra A, Muneer A, Alifrangis C, Alnajjar HM. Outcomes of penile sarcomatoid squamous cell carcinoma from a single tertiary referral centre: a matched cohort study. BJU Int 2023; 132:337-342. [PMID: 37169730 DOI: 10.1111/bju.16044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To report the oncological survival outcomes of men with penile sarcomatoid squamous cell carcinoma (sSCC). PATIENTS AND METHODS A retrospective analysis of men with penile sSCC diagnosed between January 2010 and January 2020 in a single centre was conducted. Disease-specific (DSS), recurrence-free (RFS) and metastasis-free (MFS) survival were evaluated. Outcomes were compared with a non-sarcomatoid penile SCC cohort matched to age, type of surgery and tumour stage. Kaplan-Meier plots were used to estimate survival outcomes. RESULTS In all, 1286 men were diagnosed with penile SCC during the study period and of these 38 (3%) men had sSCC. The median (interquartile range) age and follow-up was 70 (57-81) years and 16 (7-44) months, respectively. Operations performed included: circumcision, one (2.6%); wide local excision, four (10.5%); glansectomy, 11 (29%); partial penectomy, 10 (26%); subtotal/total penectomy, 12 (32%). The Kaplan-Meier estimated 12-, 24- and 36-month DSS was 62% (vs non-sarcomatoid, 67%), 43% (vs non-sarcomatoid, 67%) and 36% (vs non-sarcomatoid, 67%), respectively (P = 0.03). The Kaplan-Meier estimated 12- and 24-month RFS was 47% (vs non-sarcomatoid, 60%) and 28% (vs non-sarcomatoid, 55%), respectively (P = 0.01). The MFS was 52% (vs non-sarcomatoid, 62%) at 12 months and 37% (vs non-sarcomatoid, 57%) at 24 months (P = 0.04). CONCLUSIONS Sarcomatoid differentiation was associated with a lower DSS, RFS and MFS. Due to the rarity of its incidence and aggressiveness, expert histological review and multidisciplinary management is required in a specialist penile cancer centre.
Collapse
Affiliation(s)
- Karl H Pang
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Benedict Girling
- Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Elizabeth Osinibi
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Paramvir Sawhney
- Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Aiman Haider
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Alex Freeman
- Department of Histopathology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Paul Hadway
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Urology, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Raj Nigam
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Rowland Rees
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Urology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Anita Mitra
- Department of Clinical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Asif Muneer
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
- Department of Surgical Biotechnology, University College London, London, UK
| | - Constantine Alifrangis
- Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Hussain M Alnajjar
- Male Genital Cancer Centre, Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| |
Collapse
|
5
|
Menon S, Moch H, Berney DM, Cree IA, Srigley JR, Tsuzuki T, Compérat E, Hartmann A, Netto G, Rubin MA, Gill AJ, Turajlic S, Tan PH, Raspollini MR, Tickoo SK, Amin MB. WHO 2022 classification of penile and scrotal cancers: updates and evolution. Histopathology 2023; 82:508-520. [PMID: 36221864 DOI: 10.1111/his.14824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 09/06/2022] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
Squamous cell carcinoma (SCC) is the most common malignant tumour of the penis. The 2022 WHO classification reinforces the 2016 classification and subclassifies precursor lesions and tumours into human papillomavirus (HPV)-associated and HPV-independent types. HPV-associated penile intraepithelial neoplasia (PeIN) is a precursor lesion of invasive HPV- associated SCC, whereas differentiated PeIN is a precursor lesion of HPV-independent SCC. Block-type positivity of p16 immunohistochemistry is the most practical daily utilised method to separate HPVassociated from HPVindependent penile SCC. If this is not feasible, the term SCC, not otherwise specified (NOS) is appropriate. Certain histologies that were previously classified as "subtypes" are now grouped, and coalesced as "patterns", under the rubric of usual type SCC and verrucous carcinoma (e.g. usual-type SCC includes pseudohyperplastic and acantholytic/pseudoglandular carcinoma, and carcinoma cuniculatum is included as a pattern of verrucous carcinoma). If there is an additional component of the usual type of invasive SCC (formerly termed hybrid histology), the tumour would be a mixed carcinoma (e.g. carcinoma cuniculatum or verrucous carcinoma with usual invasive SCC); in such cases, reporting of the relative percentages in mixed tumours may be useful. The consistent use of uniform nomenclature and reporting of percentages will inform the refinement of future reporting classification schemes and guidelines/recommendations. The classification of scrotal tumours is provided for the first time in the fifth edition of the WHO Blue book, and it follows the schema of penile cancer classification for both precursor lesions and the common SCC of the scrotum. Basal cell carcinoma of the scrotum may have a variable clinical course and finds a separate mention.
Collapse
Affiliation(s)
- S Menon
- Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - H Moch
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Switzerland
| | - D M Berney
- Barts Cancer Institute, London, UK
- Department of Cellular Pathology, Barts Health NHS Trust, London, UK
| | - I A Cree
- Head, WHO Classification of Tumours Head, Evidence Synthesis and Classification, International Agency for Research on Cancer (IARC), World Health Organization, Lyon, France
| | - J R Srigley
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - T Tsuzuki
- Department of Surgical Pathology, Aichi Medical University, Aichi, Japan
| | - E Compérat
- Department of Pathology, Medical University of Vienna, General Hospital of Vienna, Wien, AT, Austria
| | - A Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander-Universitat Erlangen-Nurnberg, Erlangen, Germany
| | - G Netto
- Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - M A Rubin
- Department of Biomedical Research (DBMR), Bern Center for Precision Medicine Inselspital University Hospital Bern, Bern, Switzerland
| | - A J Gill
- Sydney Medical School Sydney, The University of Sydney, NSW, Australia
- Royal North Shore Hospital, NSW Health Pathology, Department of Anatomical Pathology St Leonards, NSW, Australia
- Royal North Shore Hospital, Pathology Group, Kolling Institute of Medical Research, St Leonards, NSW, Australia
| | - S Turajlic
- The Francis Crick Institute, London and The Royal Marsden NHS Foundation Trust, London, UK
| | - P H Tan
- Division of Pathology, Singapore General Hospital, Singapore
| | - M R Raspollini
- Histopathology and Molecular Diagnostics University Hospital Careggi, Florence, Florence, Italy
| | - S K Tickoo
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - M B Amin
- The University of Tennessee Health Science Center College of Medicine Memphis, Tennessee, USA
- Department of Urology, University of Southern California, Keck School of Medicine, USA
| |
Collapse
|
6
|
Teixeira Júnior AAL, da Costa Melo SP, Pinho JD, Sobrinho TBM, Rocha TMS, Duarte DRD, de Oliveira Barbosa L, Duarte WE, de Castro Belfort MR, Duarte KG, da Silva Neto AL, de Ribamar Rodrigues Calixto J, Paiva Paiva LC, do Nascimento FSMS, Alencar Junior AM, Khayat AS, da Graça Carvalhal Frazão Corrêa R, Lages JS, Dos Reis RB, Araújo WS, Silva GEB. A comprehensive analysis of penile cancer in the region with the highest worldwide incidence reveals new insights into the disease. BMC Cancer 2022; 22:1063. [PMID: 36243680 PMCID: PMC9569053 DOI: 10.1186/s12885-022-10127-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although penile cancer (PC) is uncommon in developed countries, it is widespread in developing countries. The state of Maranhão (Northeast, Brazil) has the highest global incidence recorded for PC, and, despite its socioeconomic vulnerability, it has been attributed to human papillomavirus (HPV) infection. This study aimed to determine the histopathological features, the prevalence of HPV infection, and the immunohistochemical profile of PC in Maranhão. METHODS A retrospective cohort of 200 PC cases were evaluated. HPV detection was performed using nested-PCR followed by direct sequencing for genotyping. Immunohistochemistry (IHC) was performed using monoclonal antibodies anti-p16INK4a, p53, and ki-67. RESULTS Our data revealed a delay of 17 months in diagnosis, a high rate of penile amputation (96.5%), and HPV infection (80.5%) in patients from Maranhão (Molecular detection). We demonstrated the high rate of HPV in PC also by histopathological and IHC analysis. Most patients presented koilocytosis (75.5%), which was associated with those reporting more than 10 different sexual partners during their lifetime (p = 0.001). IHC revealed frequent p16INK4a overexpression (26.0%) associated with basaloid (p < 0.001) and high-grade tumors (p = 0.008). Interestingly, p16 appears not to be a better prognostic factor in our disease-free survival analysis, as previously reported. We also demonstrated high ki-67 and p53 expression in a subset of cases, which was related to worse prognostic factors such as high-grade tumors, angiolymphatic and perineural invasion, and lymph node metastasis. We found a significant impact of high ki-67 (p = 0.002, log-rank) and p53 (p = 0.032, log-rank) expression on decreasing patients' survival, as well as grade, pT, stage, pattern, and depth of invasion (p < 0.05, log-rank). CONCLUSIONS Our data reaffirmed the high incidence of HPV infection in PC cases from Maranhão and offer new insights into potential factors that may contribute to the high PC incidence in the region. We highlighted the possible association of HPV with worse clinical prognosis factors, differently from what was observed in other regions. Furthermore, our IHC analysis reinforces p16, ki-67, and p53 expression as important diagnosis and/or prognosis biomarkers, potentially used in the clinical setting in emerging countries such as Brazil.
Collapse
Affiliation(s)
- Antonio Augusto Lima Teixeira Júnior
- Department of Genetics and Postgraduate Program in Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.,Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil
| | - Syomara Pereira da Costa Melo
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | - Thaís Bastos Moraes Sobrinho
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Thalita Moura Silva Rocha
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil.,Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Denner Rodrigo Diniz Duarte
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Liseana de Oliveira Barbosa
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Wesliany Everton Duarte
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil.,Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Marta Regina de Castro Belfort
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil.,Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil
| | - Kelly Gomes Duarte
- Postgraduate Program in Clinical Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Antonio Lima da Silva Neto
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | - Lúcio Cristiano Paiva Paiva
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | - Antonio Machado Alencar Junior
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil.,University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | | | | | - Joyce Santos Lages
- University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Rodolfo Borges Dos Reis
- Postgraduate Program in Clinical Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Wilson Silva Araújo
- Department of Genetics and Postgraduate Program in Genetics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Gyl Eanes Barros Silva
- Postgraduate Program in Adult Health, Federal University of Maranhão, São Luís, Brazil. .,Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil. .,Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Brazil.
| |
Collapse
|
7
|
|
8
|
Li K, Le X, Wang J, Fan C, Sun J. Tumor Location May Independently Predict Survival in Patients With M0 Squamous Cell Carcinoma of the Penis. Front Oncol 2022; 12:927088. [PMID: 35865480 PMCID: PMC9294313 DOI: 10.3389/fonc.2022.927088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo determine the association between tumor location and both clinicopathological characteristics and the survival of patients with M0 squamous cell carcinoma of the penis (SCCP).MethodsData of 455 patients diagnosed with M0 SCCP between 1975 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database of the United States National Cancer Institute. The effects of tumor location on overall survival (OS) and penile carcinoma-specific survival (PCSS) were analyzed using the Kaplan–Meier method. The Cox proportional hazards regression model was used to determine the impact of tumor location on PCSS.ResultsSCCP was more likely to occur in the prepuce or glans (90%). Although no significant difference was observed between the OS of patients with M0 SCCP in the prepuce or glans and those with M0 SCCP in the body of the penis (p = 0.307), the former had better PCSS (p = 0.024). Moreover, M0 SCCP in the prepuce or glans was also significantly associated with better PCSS in patients with advanced age (age ≥ 60 years, p = 0.011), other ethnicities (p = 0.003), T2–T4 stage (p = 0.036), larger tumors (≥3 cm, p = 0.001), no regional lymph nodes removed (p = 0.044), and radical surgery (p = 0.027). Multivariate analysis confirmed that tumor location is an independent prognostic factor for patients with M0 SCCP [hazard ratio (HR) 1.881, p = 0.026].ConclusionsTumor location is an independent prognostic factor for patients with M0 SCCP, and tumors in the prepuce or glans portend better PCSS.
Collapse
Affiliation(s)
| | | | | | - Caibin Fan
- *Correspondence: Caibin Fan, ; Jian Sun,
| | - Jian Sun
- *Correspondence: Caibin Fan, ; Jian Sun,
| |
Collapse
|
9
|
Spencer A, Watchorn RE, Kravvas G, Ben-Salha I, Haider A, Francis N, Freeman A, Alnajjar HM, Muneer A, Bunker CB. Pseudoepitheliomatous keratotic and micaceous balanitis: a series of eight cases. J Eur Acad Dermatol Venereol 2022; 36:1851-1856. [PMID: 35695159 DOI: 10.1111/jdv.18328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 05/05/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Pseudoepitheliomatous keratotic and micaceous balanitis (PEKMB) is a clinicopathological entity characterized clinically by micaceous scale on the glans, and histologically by acanthosis, hyperkeratosis and pseudoepitheliomatous hyperplasia. We present a series of eight cases of this rare condition, the first series of more than two cases to be reported. OBJECTIVES To determine the clinical and histological characteristics of cases of PEKMB, and evaluate treatments used and clinical course. METHODS This monocentric case series was conducted at the University College London Hospitals tertiary male genital dermatology clinic between April 2018 and August 2020. Eight patients with PEKMB were evaluated. Data were collected on demographics, clinical presentation, histological features, presence of human papilloma virus (HPV), history of lichen sclerosus, treatment of PEKMB and subsequent response, and presence or development of squamous cell carcinoma (SCC) or penile intraepithelial neoplasia (PeIN) during follow-up. RESULTS Eight Caucasian males presented with clinical and histological evidence of PEKMB. Seven had a background of lichen sclerosus; two had failed treatment with superpotent topical steroids and four had symptoms for three or more years prior to circumcision. There was no clinical or histological relationship with HPV infection, and p16 staining was negative. HPV PCR, performed in two cases, was negative. Basal atypia, insufficient to amount to PeIN, was present in six patients. One patient progressed to PeIN during follow-up, and no patient progressed to invasive malignancy. Five patients were treated successfully with glans resurfacing and split skin graft reconstruction. CONCLUSIONS Our observations demonstrate that PEKMB represents a form of chronic, undiagnosed or misdiagnosed, inadequately treated or treatment refractory, unstable lichen sclerosus. The significant potential for squamous carcinogenesis (differentiated PeIN and verrucous carcinoma) can be mitigated by timely diagnosis and treatment. Glans resurfacing and split skin graft reconstruction appears to be a successful treatment modality in patients with refractory disease.
Collapse
Affiliation(s)
- A Spencer
- Department of Dermatology, University College London Hospitals NHS Trust, London, UK.,Department of Dermatology, Imperial College Healthcare NHS Trust, London, UK
| | - R E Watchorn
- Department of Dermatology, University College London Hospitals NHS Trust, London, UK.,Department of Dermatology, Imperial College Healthcare NHS Trust, London, UK
| | - G Kravvas
- Department of Dermatology, University College London Hospitals NHS Trust, London, UK
| | - I Ben-Salha
- Department of Histopathology, University College London Hospitals NHS Trust, London, UK
| | - A Haider
- Department of Histopathology, University College London Hospitals NHS Trust, London, UK
| | - N Francis
- Department of Histopathology, Imperial College Healthcare NHS Trust, London, UK
| | - A Freeman
- Department of Histopathology, University College London Hospitals NHS Trust, London, UK
| | - H M Alnajjar
- Department of Urology, University College London Hospitals NHS Trust, London, UK
| | - A Muneer
- Department of Urology, University College London Hospitals NHS Trust, London, UK.,National Institute of Health Research Centre, University College London Hospitals NHS Trust, London, UK.,Division of Surgery and Interventional Science, University College London, London, UK
| | - C B Bunker
- Department of Dermatology, University College London Hospitals NHS Trust, London, UK
| |
Collapse
|
10
|
[Penile intraepithelial neoplasia]. Ann Pathol 2021; 42:15-19. [PMID: 34865881 DOI: 10.1016/j.annpat.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/25/2021] [Accepted: 04/29/2021] [Indexed: 11/20/2022]
Abstract
Penile carcinogenesis can be superposed on vulvar carcinogenesis, with two pathways : with or without a link to HPV. Penile squamous cell carcinomas arise from precursor lesions: penile intraepithelial neoplasia (PeIN) defined by the presence of intraepithelial atypia, which can progress to invasive squamous cell carcinoma. Differentiated PeINs not linked to HPV, affect elderly men with inflammatory lesions, most often lichen sclerosus. PeINs linked to HPV, basaloid, condylomatous or condylomatous-basaloid growth affect younger men. Although clinically similar, their distinction is important, because the treatment differs with a greater risk of invasion for forms unrelated to HPV.
Collapse
|
11
|
Li K, Wu G, Fan C, Yuan H. The prognostic significance of primary tumor size in squamous cell carcinoma of the penis. Discov Oncol 2021; 12:22. [PMID: 35201454 PMCID: PMC8777549 DOI: 10.1007/s12672-021-00416-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 07/01/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND To evaluate the association of primary tumor size with clinicopathologic characteristics and survival of patients with squamous cell carcinoma of the penis (SCCP). METHODS This study analyzed the data of 1001 patients with SCCP, obtained from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2014. The Kaplan-Meier method and the Cox proportional hazards regression model were used to analyze the effects of primary tumor size on overall survival (OS) and penile carcinoma-specific survival (PCSS). RESULTS Advanced T stage (P < 0.001), lymph node metastasis (P < 0.001) and distant metastasis (P = 0.001) were more frequently associated with SCCP patients with tumor size ≥ 3 cm than those with tumor size < 3 cm. In Kaplan-Meier analyses, the patients with large tumors (≥ 3 cm) exhibited an inferior OS and PCSS than those with small tumors (< 3 cm). Moreover, tumor size was identified to be an independent prognostic factor for OS [hazard ratio (HR) 1.665, P < 0.001] and PCSS (HR 2.076, P = 0.003) of patients with SCCP in multivariate analyses. CONCLUSIONS Large tumor size is associated with adverse clinicopathological characteristics of patients with SCCP. Besides, tumor size represents an independent prognostic factor for OS and PCSS. Therefore, clinical assessment of tumor size as a crucial prognostic factor might be highly beneficial for early intervention in patients with SCCP.
Collapse
Affiliation(s)
- Kai Li
- Department of Urology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Guang Wu
- Department of Urology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Caibin Fan
- Department of Urology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China.
| | - Hexing Yuan
- Department of Urology, First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215000, Jiangsu Province, People's Republic of China.
| |
Collapse
|
12
|
Thomas A, Necchi A, Muneer A, Tobias-Machado M, Tran ATH, Van Rompuy AS, Spiess PE, Albersen M. Penile cancer. Nat Rev Dis Primers 2021; 7:11. [PMID: 33574340 DOI: 10.1038/s41572-021-00246-5] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 12/27/2022]
Abstract
Penile squamous cell carcinoma (PSCC) is a rare cancer with orphan disease designation and a prevalence of 0.1-1 per 100,000 men in high-income countries, but it constitutes up to 10% of malignancies in men in some African, Asian and South American regions. Risk factors for PSCC include the absence of childhood circumcision, phimosis, chronic inflammation, poor penile hygiene, smoking, immunosuppression and infection with human papillomavirus (HPV). Several different subtypes of HPV-related and non-HPV-related penile cancers have been described, which also have different prognostic profiles. Localized disease can be effectively managed by topical therapy, surgery or radiotherapy. As PSCC is characterized by early lymphatic spread and imaging is inadequate for the detection of micrometastatic disease, correct and upfront surgical staging of the inguinal lymph nodes is crucial in disease management. Advanced stages of disease require multimodal management. Optimal sequencing of treatments and patient selection are still being investigated. Cisplatin-based chemotherapy regimens are the mainstay of systemic therapy for advanced PSCC, but they have poor and non-durable responses and high rates of toxic effects, indicating a need for the development of more effective and less toxic therapeutic options. Localized and advanced penile cancers and their treatment have profound physical and psychosexual effects on the quality of life of patients and survivors by altering sexual and urinary function and causing lymphoedema.
Collapse
Affiliation(s)
- Anita Thomas
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.,Department of Urology, University Hospitals Leuven, Leuven, Belgium.,Department of Urology and Pediatric Urology, University Medical Center Mainz, Mainz, Germany
| | - Andrea Necchi
- Genitourinary Medical Oncology, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Italy
| | - Asif Muneer
- Department of Urology, University College London Hospitals, London, UK.,National Institute for Health Research (NIHR) Biomedical Research Centre, University College London Hospitals, London, UK.,Division of Surgery and Interventional Science, University College London, London, UK
| | - Marcos Tobias-Machado
- Section of Urologic Oncology, Department of Urology, ABC Medical School, Instituto do Cancer Vieira de Carvalho, São Paulo, Brazil
| | - Anna Thi Huyen Tran
- Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK
| | | | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Maarten Albersen
- Laboratory of Experimental Urology, Department of Development and Regeneration, KU Leuven, Leuven, Belgium. .,Department of Urology, University Hospitals Leuven, Leuven, Belgium.
| |
Collapse
|
13
|
Zheng W, Li K, Zhu W, Ding Y, Wu Q, Tang Q, Lu C, Zhao Q, Yu S, Guo C. Nomogram prediction of overall survival based on log odds of positive lymph nodes for patients with penile squamous cell carcinoma. Cancer Med 2020; 9:5425-5435. [PMID: 32519819 PMCID: PMC7402844 DOI: 10.1002/cam4.3232] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to establish a nomogram to predict the long‐term overall survival (OS) for patients with penile squamous cell carcinoma (PSCC). Method The PSCC patients receiving regional lymph node dissection (RLND) were enrolled from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015. The dataset of all eligible patients were used to develop the predictive model. The significant independent predictors were identified through Cox regression modeling based on the Bayesian information criterion and then incorporated into a nomogram to predicted 1‐, 3‐, and 5‐year OS. Internal validation was performed using the bootstrap resampling method. The model performance was evaluated using Harrell's concordance index (C‐index), calibration plots, integrated discrimination improvement (IDI), net reclassification improvement (NRI), and decision curve analysis (DCA). Results Totally, 384 eligible PSCC patients were enrolled from the SEER database. A nomogram for OS prediction was developed, in which three clinical variables significantly associated with OS were integrated, including age, N classification, and log odds of positive lymph nodes (LODDS). The C‐index of the nomogram (0.746, 95% CI: 0.702‐0.790) was significantly higher than that of the American Joint Committee on Cancer (AJCC) staging system (0.692, 95% CI: 0.646‐0.738, P = .020). The bootstrap optimism‐corrected C‐index for the nomogram was 0.739 (95% CI: 0.690‐0.784). The bias‐corrected calibration plots showed the predicted risks were in good accordance with the actual risks. The results of NRI, IDI, and DCA exhibited superior predictive capability and higher clinical use of the nomogram compared with the AJCC staging system. Conclusion We successfully constructed a simple and reliable nomogram for OS prediction among PSCC patients receiving RLND, which would be beneficial to clinical trial design, patient counseling, and therapeutic modality selection.
Collapse
Affiliation(s)
- Wenwen Zheng
- Department of Education, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Kangqi Li
- Drug Clinical Trial Agency, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Weiwei Zhu
- Drug Clinical Trial Agency, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Yuexia Ding
- Department of Pharmacy, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Qingna Wu
- Department of Pharmacy, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Qiling Tang
- Department of Pharmacy, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Congxiao Lu
- Drug Clinical Trial Agency, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Quan Zhao
- Department of Pharmacy, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Shengqiang Yu
- Department of Urology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| | - Chenyu Guo
- Drug Clinical Trial Agency, Yantai Yuhuangding Hospital, Qingdao University, Yantai, China
| |
Collapse
|
14
|
Racial/ethnic disparities in penile squamous cell carcinoma incidences, clinical characteristics, and outcomes: A population-based study, 2004-2016. Urol Oncol 2020; 38:688.e11-688.e19. [PMID: 32340796 DOI: 10.1016/j.urolonc.2020.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/23/2020] [Accepted: 03/05/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE This study assessed the impact of race/ethnicity on penile squamous cell carcinoma (PSCC) incidence rates, clinical characteristics, and outcomes. MATERIALS AND METHODS Surveillance, Epidemiology and End Results data from 2004 to 2016 was used for this study. We evaluated racial/ethnic differences in clinical characteristics using χ2 tests. Overall survival (OS) and PSCC-specific survival (PSCC-SS) were estimated using the Kaplan-Meier method, and differences were determined using the log-rank test. Cox regression models were performed to assess independent predictors for PSCC patient survival. RESULTS A total of 2,720 PSCC patients were included for incidence analysis, and 2,438 patients were identified for the χ2 testing and survival analyses.The overall incidence of PSCC during 2004 to 2016 was 0.30 per 100,000. Only non-Hispanic white (NHW) patients had a statistically significant increase in age-adjusted incidence rates (annual percent change = 2.26, 95% confidence interval [CI]: 0.78-3.76; P = 0.01). In univariate analysis, race/ethnicity was an independent prognostic factor for OS and PSCC-SS. After adjusting for age, marital status, income, grade, TNM (tumor, node, metastasis) stage, and treatment strategies, non-Hispanic black patients still had a statistically significant hazard ratio of 1.35 (95% CI: 1.08-1.68; P = 0.007) for OS, and a hazard ratio of 1.36 (95% CI: 1.01-1.82; P = 0.045) for PSCC-SS compared to NHW. CONCLUSION NHW patients had a statistically significant increase in age-adjusted incidence rate during the period 2004 to 2016. Race/ethnicity is an independent prognostic factor for OS and PSCC-SS, and non-Hispanic black were proven to have unfavorable OS and PSCC-SS compared with NHW.
Collapse
|
15
|
Macedo J, Silva E, Nogueira L, Coelho R, da Silva J, Dos Santos A, Teixeira-Júnior AA, Belfort M, Silva G, Khayat A, de Oliveira E, Dos Santos AP, Cavalli LR, Pereira SR. Genomic profiling reveals the pivotal role of hrHPV driving copy number and gene expression alterations, including mRNA downregulation of TP53 and RB1 in penile cancer. Mol Carcinog 2020; 59:604-617. [PMID: 32212199 DOI: 10.1002/mc.23185] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 02/26/2020] [Accepted: 03/02/2020] [Indexed: 12/13/2022]
Abstract
The incidence of penile cancer (PeCa) is increasing worldwide, however, the highest rates are reported in underdeveloped countries. The molecular mechanisms that underly the onset and progression of these tumors are still unclear. Therefore, our goal was to determine the genome-wide copy number alterations and the involvement of human papiloma virus (HPV) (TP53 and RB1), inflammatory (COX2 and EGFR), and PI3K/AKT pathway (AKT1, AKT2, EGFR, ERBB3, ERBB4, PIK3CA, and PTEN) associated genes in patients with PeCa from a high incidence region in Brazil (Maranhão). HPV genotyping was performed by nest-PCR and genome sequencing, copy number alterations (CNAs) by array comparative genomic hybridization and gene copy number status, gene, and protein expression by quantitative polymerase chain reaction, reverse transcriptase-quantitative polymerase chain reaction, and immunohistochemistry, respectively. HPV genotyping revealed one of the highest frequencies of HPV reported in PeCa, affecting 96.4% of the cases. The most common CNAs observed were located at the HPV integration sites, such as 2p12-p11.2 and 14q32.33, where ADAM 6, KIAA0125, LINC00226, LINC00221, and miR7641-2, are mapped. Increased copy number of ERBB3 and EGFR genes were observed in association with COX2 and EGFR overexpression, reinforcing the role of the inflammatory pathway in PeCa, and suggesting anti-EGFR and anti-COX2 inhibitors as promising therapies for PeCa. Additionally, TP53 and RB1 messenger RNA downregulation was observed, suggesting the occurrence of other mechanisms for repression of these oncoproteins, in addition to the canonical HPV/TP53/RB1 signaling pathway. Our data reinforce the role of epigenetic events in abnormal gene expression in HPV-associated carcinomas and suggest the pivotal role of HPV driving CNAs and controlling gene expression in PeCa.
Collapse
Affiliation(s)
- Juliana Macedo
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Elis Silva
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Ronald Coelho
- Aldenora Bello Cancer Hospital, São Luís, Maranhão, Brazil
| | - Jenilson da Silva
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Maranhão, Brazil.,Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Alcione Dos Santos
- Public Health Department, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | - Marta Belfort
- Postgraduate Program in Health Science, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Gyl Silva
- Biology Undergraduate Course, Department of Pathology, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - André Khayat
- Oncology Research Center, Federal University of Pará, Belém, Pará, Brazil
| | - Edivaldo de Oliveira
- Tissue Culture and Cytogenetics Laboratory, Institute of Evandro Chagas, Belém, Pará, Brazil
| | - Ana Paula Dos Santos
- Department of Physiological Sciences, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Luciane R Cavalli
- Faculdades Pequeno Príncipe, Instituto de Pesquisa Pelé Pequeno Príncipe, Curitiba, Paraná, Brazil.,Department of Oncology, Georgetown Lombardi Comprehensive Cancer Center, Washington, District of Columbia, United States
| | - Silma Regina Pereira
- Laboratory of Genetics and Molecular Biology, Department of Biology, Federal University of Maranhão, São Luís, Maranhão, Brazil
| |
Collapse
|
16
|
The molecular pathogenesis of penile carcinoma—current developments and understanding. Virchows Arch 2019; 475:397-405. [DOI: 10.1007/s00428-019-02607-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/30/2019] [Accepted: 06/10/2019] [Indexed: 12/11/2022]
|
17
|
Li K, Sun J, Wei X, Wu G, Wang F, Fan C, Yuan H. Prognostic value of lymphovascular invasion in patients with squamous cell carcinoma of the penis following surgery. BMC Cancer 2019; 19:476. [PMID: 31113402 PMCID: PMC6528249 DOI: 10.1186/s12885-019-5714-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 05/14/2019] [Indexed: 12/16/2022] Open
Abstract
Background To evaluate the prognostic value of Lymphovascular Invasion (LVI) in patients with squamous cell carcinoma of the penis (SCCP) following surgery. Patients and methods This retrospective study analyzed the data of 891 eligible patients with SCCP who were diagnosed between 2010 and 2014, obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were categorized by LVI, age, grade, T stage, lymph nodes status, distant metastasis, regional lymph nodes removed, and surgery. Overall survival (OS) and penile carcinoma-specific survival (PCSS) were evaluated by Kaplan-Meier method and Cox proportional hazards regression model. Results The presence of LVI was significantly associated with increased risk of advanced T stage, high grade, lymph node metastasis, and distant metastasis (P < 0.001 for all). In Kaplan-Meier analyses, patients with the presence of LVI had significantly lower OS and PCSS than those with the absence of LVI (P < 0.001 for both,). The presence of LVI was also significantly associated with poorer OS and worse PCSS in patients with Tx + Ta + T1 stage (P = 0.007, P < 0.001), N0 stage (P < 0.001, P = 0.040), grade 1 (P = 0.001, P < 0.001), grade 2 (P = 0.001, P = 0.014), no distant metastasis (P < 0.001 for both), no regional lymph nodes removed (P < 0.001 for both), Non-radical surgery (P < 0.001 for both) and radical surgery(P = 0.037, P = 0.002). In multivariate analyses, the presence of LVI in patients with SCCP following surgery was found to be a significant independent predictor of decreased OS (hazard ratio 1.403, P = 0.039). Conclusions The LVI status might be a crucial prognostic indicator for overall survival in patients with SCCP.
Collapse
Affiliation(s)
- Kai Li
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Jian Sun
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Xuedong Wei
- Department of Urology, First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Guang Wu
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Fei Wang
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Caibin Fan
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China.
| | - Hexing Yuan
- Department of Urology, First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215000, Jiangsu Province, People's Republic of China.
| |
Collapse
|
18
|
Organ-Sparing Surgery for a Giant Verrucous Carcinoma of the Penile Shaft: A Case Report and Review of the Literature. Case Rep Urol 2019; 2019:1537379. [PMID: 30918740 PMCID: PMC6408996 DOI: 10.1155/2019/1537379] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 01/30/2019] [Indexed: 11/18/2022] Open
Abstract
Verrucous Carcinoma is a rare but well-differentiated variant of penile squamous cell carcinoma. Its clinical presentation is usually that of an exophytic cauliflower-like lesion with a broad-based growth pattern. We herein report the case of a 61-year-old man who presented with a giant verrucous carcinoma occupying the dorsal surface of the penile shaft. The patient underwent penile-sparing surgery, achieving both disease control and organ preservation. We discuss relevant issues, including clinical features, diagnosis, surgical management, and prognosis and we review the rather sparse literature regarding this rare lesion.
Collapse
|
19
|
Morse DC, Tschen JA, Silapunt S. A Rare Variant of Penile Squamous Cell Carcinoma in a Man with Paraplegia. Cureus 2018; 10:e3244. [PMID: 30416897 PMCID: PMC6217864 DOI: 10.7759/cureus.3244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Verrucous carcinoma (VC) is a rare variant of squamous cell carcinoma (SCC). It is described as a low grade, slow growing, locally infiltrative neoplasm that accounts for 3%-8% of penile SCCs. Here we report a case of destructive VC of the glans penis in a paraplegic man resulting in a hypospadias from the tip of the glans to the corona. Histology demonstrated exophytic squamous epithelial proliferation with characteristic round, pushing borders. In situ hybridization was positive for both low-risk and high-risk strains of human papillomavirus.
Collapse
Affiliation(s)
- Daniel C Morse
- Mcgovern Medical School, University of Texas Mcgovern Medical School at Houston, Houston, USA
| | - Jaime A Tschen
- Dermatopathology, St Joseph Dermatopathology, Houston, USA
| | - Sirunya Silapunt
- Dermatology, University of Texas Mcgovern Medical School at Houston, Houston, USA
| |
Collapse
|
20
|
Kouyaté M, D'horpock AF, Aman NA, Traore ZC, Coulibaly ZI, Koui BS, Koffi KD, Koffi KE. Melanoma of the penis: A case diagnosed at the Anatomic Pathology Laboratory of the Treichville Teaching Hospital. HUMAN PATHOLOGY: CASE REPORTS 2018. [DOI: 10.1016/j.ehpc.2017.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
21
|
Marchionne E, Perez C, Hui A, Khachemoune A. Penile squamous cell carcinoma: a review of the literature and case report treated with Mohs micrographic surgery. An Bras Dermatol 2017; 92:95-99. [PMID: 28225964 PMCID: PMC5312186 DOI: 10.1590/abd1806-4841.20175009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/28/2015] [Indexed: 12/18/2022] Open
Abstract
The majority of penile carcinoma is squamous cell carcinoma. Although uncommon in the United States, it represents a larger proportion of cancers in the underdeveloped world. Invasive squamous cell carcinoma may arise from precursor lesions or de novo , and has been associated with lack of circumcision and HPV infection. Early diagnosis is imperative as lymphatic spread is associated with a poor prognosis. Radical surgical treatment is no longer the mainstay, and penile sparing treatments now are often used, including Mohs micrographic surgery. Therapeutic decisions should be made with regard to the size and location of the tumor, as well as the functional desires of the patient. It is critical for the dermatologist to be familiar with the evaluation, grading/staging, and treatment advances of penile squamous cell carcinoma. Herein, we present a review of the literature regarding penile squamous cell carcinoma, as well as a case report of invasive squamous cell carcinoma treated with Mohs micrographic surgery.
Collapse
Affiliation(s)
| | - Caroline Perez
- School of medicine - University of Nevada - Reno, United States
| | - Andrea Hui
- Department of Dermatology - State University of New York - Downstate and Veterans Affairs Medical Center - Brooklyn (NY), United States
| | - Amor Khachemoune
- Department of Dermatology - State University of New York - Downstate and Veterans Affairs Medical Center - Brooklyn (NY), United States
| |
Collapse
|
22
|
Aita GA, Zequi SDC, Costa WHD, Guimarães GC, Soares FA, Giuliangelis TS. Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy. Int Braz J Urol 2017; 42:1136-1143. [PMID: 27813383 PMCID: PMC5117969 DOI: 10.1590/s1677-5538.ibju.2015.0416] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/21/2016] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. Physical exam and image exams are not adequate to evaluate inguinal lymph nodes and many patients are submitted to non-therapeutic lymphadenectomies. However, it is known that not all patients with clinically or histologically negative inguinal lymph nodes evolve favorably. CASUISTIC AND METHODS the authors evaluated the clinical and pathologic characteristics of 163 patients with penile carcinoma and clinically negative inguinal lymph nodes followed for three or more years and their impact on global survival (GS) and cancer-specific survival (CSS) in the 10-year follow-up. Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019). CONCLUSION high histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years.
Collapse
Affiliation(s)
- Giuliano Amorim Aita
- Departamento de Urologia, Hospital Universitário - Universidade Federal do Piauí, Brasil
| | - Stênio de Cássio Zequi
- Serviço de Urologia, Departamento de Cirurgia Pélvica, A C Camargo Cancer Center, SP, Brasil
| | | | | | | | | |
Collapse
|
23
|
Faraj SF, Gonzalez-Roibon N, Munari E, Sharma R, Burnett AL, Cubilla AL, Netto GJ, Chaux A. Strong association of insulin-like growth factor 1 receptor expression with histologic grade, subtype, and HPV status in penile squamous cell carcinomas: a tissue microarray study of 112 cases. Virchows Arch 2017; 470:695-701. [PMID: 28349238 DOI: 10.1007/s00428-017-2110-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/12/2017] [Accepted: 03/15/2017] [Indexed: 01/29/2023]
Abstract
Insulin-like growth factor-1 receptor (IGF1R) plays a key role in cell growth and transformation. It is overexpressed in several solid tumors. This study evaluates IGF1R immunoexpression in penile squamous cell carcinoma (SCC). Four tissue microarrays were built from formalin-fixed, paraffin-embedded blocks of 112 penile SCC from Paraguay. Membranous IGF1R expression was evaluated by immunohistochemistry using two different approaches. An H-score was calculated in each spot (stain intensity by extent), and a median score per tumor was obtained. The second approach consisted of a score similar to the scoring system that was used for evaluating HER2 immunoexpression. For each case, the highest category obtained at any spot was used for statistical analyses. IGF1R expression was compared by histologic subtype, grade, and human papillomavirus (HPV) status. Median H-score was 22.5. The distribution of IGF1R expression by HER2 approach was as follows: 0 in 33.0% cases, 1+ in 46.4%, 2+ in 14.3%, and 3+ in 6.2%. IGF1R H-scores were associated with basaloid and warty/basaloid subtypes (p = 0.0026) and higher grade (p = 0.00052). Although weaker when using the HER2 approach, the association of IGF1R expression with subtype (p = 0.015) and grade (p = 0.015) remained significant. Furthermore, there was an association between IGF1R expression by HER2 approach and HPV status (p = 0.012). IGF1R was expressed in about two thirds of penile SCC cases, showing a strong positive association with histologic grade, subtype, and HPV status. Considering that grade is a predictor of outcome IGF1R expression may have prognostic relevance and could point to a potential role for IGF1R inhibitors in treating penile SCC.
Collapse
Affiliation(s)
- Sheila F Faraj
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - Enrico Munari
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Rajni Sharma
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Arthur L Burnett
- Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - George J Netto
- Johns Hopkins Medical Institutions, Baltimore, MD, USA. .,Department of Pathology, The University of Alabama at Birmingham, WP Building, Suite P230 l 619 19th Street, South, Birmingham, AL, 35249-7331, USA.
| | - Alcides Chaux
- Centro para el Desarrollo de la Investigación Científica (CEDIC), Asunción, Paraguay
| |
Collapse
|
24
|
Aragon-Ching JB, Pagliaro LC. New Developments and Challenges in Rare Genitourinary Tumors: Non-Urothelial Bladder Cancers and Squamous Cell Cancers of the Penis. Am Soc Clin Oncol Educ Book 2017; 37:330-336. [PMID: 28561704 DOI: 10.1200/edbk_175558] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The diagnosis and treatment of rare genitourinary tumors is inherently challenging. The Rare Diseases Act of 2002 initially defined a rare disorder as one that affects fewer than 200,000 Americans. The lack of widely available clinical guidelines, limited research funding, and inaccessible clinical trials often lead to difficulty with treatment decisions to guide practitioners in rendering effective care for patients with rare genitourinary cancers. This article will discuss basic tenets of diagnosis and treatment as well as recent developments and clinical trials in rare non-urothelial bladder cancers and penile squamous cell cancers.
Collapse
Affiliation(s)
- Jeanny B Aragon-Ching
- From the Inova Schar Cancer Institute, Fairfax, VA; Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
| | - Lance C Pagliaro
- From the Inova Schar Cancer Institute, Fairfax, VA; Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN
| |
Collapse
|
25
|
Silva Amancio AMTD, Cunha IWD, Neves JI, Quetz JDS, Carraro DM, Rocha RM, Zequi SC, Cubilla AL, da Fonseca FP, Lopes A, Cunha MDPSSD, Lima MVA, Vassallo J, Guimarães GC, Soares FA. Epidermal growth factor receptor as an adverse survival predictor in squamous cell carcinoma of the penis. Hum Pathol 2016; 61:97-104. [PMID: 27864120 DOI: 10.1016/j.humpath.2016.07.041] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/07/2016] [Accepted: 07/15/2016] [Indexed: 01/03/2023]
Abstract
Penile carcinoma (PC) is more frequent in underdeveloped countries, generally is diagnosed at an advanced stage when therapeutic options are restricted, and thus is associated with high morbidity/mortality rates. Recent studies have demonstrated clinical benefits with epidermal growth factor receptor (EGFR)-targeted therapy in patients with PC, although there is no test that provides accurate patient selection. The aim of the present study was to evaluate the prognostic value of EGFR gene and protein status in tumor samples from patients with primary penile squamous cell carcinoma. We assessed the expression of wild-type and 2 mutant EGFR isoforms (delA746-E750 and mL858R) by immunohistochemistry in 139 samples, of which 49 were also evaluated for EGFR copy number by fluorescence in situ hybridization (FISH). Positive immunohistochemical staining of wild-type and mutant EGFR was evidenced by complete and strong membranous staining. For FISH analysis, cases were considered unaltered, polysomic, or amplified, as determined by signals of the EGFR gene and chromosome 7. An independent cohort of 107 PC samples was evaluated for mutations in EGFR, KRAS, and BRAF. Protein overexpression was noted in nearly half of the cases and was associated with cancer recurrence (P=.004) and perineural invasion (P=.005). Expression of the 2 mutated EGFR isoforms was not observed. The FISH status was not associated with protein expression. Altered FISH (polysomy and gene amplification) was an independent risk factor for dying of cancer. Only 1 patient of 107 presented KRAS mutations, and no mutations of EGFR or BRAF were observed.
Collapse
Affiliation(s)
| | | | - José Ivanildo Neves
- Department of Anatomic Pathology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | | | - Dirce Maria Carraro
- Department of Anatomic Pathology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | - Rafael Malagoli Rocha
- Department of Anatomic Pathology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | - Stenio Cássio Zequi
- Urology Division, Department of Pelvic Surgical Oncology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | - Antonio Leopoldo Cubilla
- Instituto de Patologia e Investigacion, Universidad Nacional de Asuncion, 1617, Asuncion, Paraguay
| | - Francisco Paulo da Fonseca
- Urology Division, Department of Pelvic Surgical Oncology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | - Ademar Lopes
- Urology Division, Department of Pelvic Surgical Oncology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | | | | | - José Vassallo
- Department of Anatomic Pathology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil; Laboratory of Molecular and Investigative Pathology, Faculty of Medical Sciences, State University of Campinas Medical School, 13083-970, Campinas, SP, Brazil
| | - Gustavo Cardoso Guimarães
- Urology Division, Department of Pelvic Surgical Oncology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil
| | - Fernando Augusto Soares
- Department of Anatomic Pathology, A.C. Camargo Cancer Center, 01508-010, São Paulo, SP, Brazil; General Pathology, Faculty of Dentistry, University of São Paulo, 05508-000, São Paulo, SP, Brazil.
| |
Collapse
|
26
|
Abstract
In addition to practitioners who care for male patients, with the increased use of high-resolution anoscopy, practitioners who care for women are seeing more men in their practices as well. Some diseases affecting the penis can impact on their sexual partners. Many of the lesions and neoplasms of the penis occur on the vulva as well. In addition, there are common and rare lesions unique to the penis. A review of the scope of penile lesions and neoplasms that may present in a primary care setting is presented to assist in developing a differential diagnosis if such a patient is encountered, as well as for practitioners who care for their sexual partners. A familiarity will assist with recognition, as well as when consultation is needed.
Collapse
|
27
|
Rush PS, Shiau JM, Hibler BP, Longley BJ, Downs TM, Bennett DD. Primary cutaneous adenosquamous carcinoma of the penis: the first characterization of HPV status in this rare and diagnostically challenging entity with review of glandular carcinomas of the penis. J Cutan Pathol 2016; 43:1226-1230. [PMID: 27696488 DOI: 10.1111/cup.12835] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Revised: 09/17/2016] [Accepted: 09/25/2016] [Indexed: 11/30/2022]
Abstract
Glandular and pseudoglandular tumors of the penile skin are extremely uncommon and can present diagnostic challenges. Primary adenosquamous carcinoma of the penis is an extremely rare tumor, composed of distinct areas of malignant squamous and glandular cells, making it a diagnostically challenging entity. The World Health Organization (WHO) recognizes several subtypes of squamous cell carcinoma (SCC), each with its own distinctive pathologic appearance, clinical associations and prognosis. Among these variants is the exceedingly uncommon adenosquamous carcinoma (ASC), representing 1%-2% of all SCC of the penis. Recent large studies have interrogated the presence of human papillomavirus (HPV) in malignant penile tumors and have shown specific morphologic patterns and clinical presentations to associate with HPV status. However, given the rarity of the adenosquamous variant of SCC, it has largely been excluded from these studies. The glandular components of these lesions can present a confusing appearance, particularly when a large tumor is represented on a small biopsy. Here we describe a difficult histologic presentation of this rare tumor, with the first published characterization of the HPV status of this subtype. This case represents a distinctly unusual case of metastatic HPV-positive primary cutaneous adenosquamous carcinoma of the penis.
Collapse
Affiliation(s)
- P S Rush
- Department of Pathology & Laboratory Medicine, University of Wisconsin Hospital and Clinics, Madison, WI, USA
| | - J M Shiau
- Department of Urology, University of Wisconsin Hospital and Clinics, Madison, WI, USA
| | - B P Hibler
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - B J Longley
- Department of Dermatology, University of Wisconsin Hospital and Clinics, Madison, WI, USA
| | - T M Downs
- Department of Urology, University of Wisconsin Hospital and Clinics, Madison, WI, USA
| | - D D Bennett
- Department of Dermatology, University of Wisconsin Hospital and Clinics, Madison, WI, USA
| |
Collapse
|
28
|
Wachtel MS, Yang S, Morris BJ. Countries with high circumcision prevalence have lower prostate cancer mortality. Asian J Androl 2016; 18:39-42. [PMID: 26323559 PMCID: PMC4736355 DOI: 10.4103/1008-682x.159713] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The present study determined the relationship of male circumcision (MC) prevalence with prostatic carcinoma mortality rate in the 85 countries globally for which data on each were available. MC prevalence in different countries were obtained from a WHO report and allocated to WHO categories of 81%–100%, 20%–80%, and 0%–19%. Prostatic carcinoma mortality data were from Globoscan, gross national income per capita as well as male life expectancy were from a World Bank report, and percentages of Jews and Muslims by country were from the Pew Research Institute and the North American Jewish Data Bank. Negative binomial regression was used to estimate prostatic carcinoma mortality rate ratios. Compared to countries with 81%–100% MC prevalence, prostatic carcinoma mortality rate was higher in those with MC prevalence of 0%–19% (adjusted OR [adjOR] =1.82; 95% CI 1.14, 2.91) and 20%–80% (adjOR = 1.80; 95% CI, 1.16, 2.78). Higher Muslim percentage (adjOR = 0.92 [95% CI 0.87, 0.98] for each 10% increase) and longer life expectancy (adjOR = 0.82 [95% CI 0.72, 0.93] for each 5 additional years) were associated with lower prostatic carcinoma mortality. Higher gross national income per capita (adjOR = 1.10 [95% CI 1.01, 1.20] for double this parameter) correlated with higher mortality. Compared with American countries, prostatic carcinoma mortality rate was similar in Eastern Mediterranean countries (adjOR = 1.02; 95% CI 0.58, 1.76), but was lower in European (adjOR = 0.60; 95% CI 0.50, 0.74) and Western Pacific countries (adjOR = 0.54, 95% CI 0.37, 0.78). Thus, prostate cancer mortality is significantly lower in countries in which MC prevalence exceeds 80%.
Collapse
Affiliation(s)
| | | | - Brian J Morris
- School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
29
|
Dauendorffer JN, Cavelier-Balloy B, Bagot M, Renaud-Vilmer C. [Male genital Buschke-Löwenstein tumour]. Ann Dermatol Venereol 2016; 143:796-798. [PMID: 27527568 DOI: 10.1016/j.annder.2016.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 06/04/2016] [Accepted: 06/21/2016] [Indexed: 11/18/2022]
Affiliation(s)
- J-N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
| | - B Cavelier-Balloy
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - M Bagot
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| | - C Renaud-Vilmer
- Service de dermatologie, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France
| |
Collapse
|
30
|
A comprehensive characterization of cell cultures and xenografts derived from a human verrucous penile carcinoma. Tumour Biol 2016; 37:11375-84. [PMID: 26960831 DOI: 10.1007/s13277-016-4951-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 01/29/2016] [Indexed: 12/15/2022] Open
Abstract
This study aimed to establish and characterize primary cell cultures and xenografts derived from penile carcinoma (PeCa) in order to provide experimental models for cellular processes and efficacy of new treatments. A verrucous squamous cell carcinoma (VSCC) was macrodissected, dissociated, and cultivated in KSFM/DF12 medium. Cell cultures were evaluated at passage 5 (P5) using migration and invasion assays and were serially propagated, in vivo, in BALB/c nude mice until passage 3 (X1-X3). Immunophenotypic characterization of cultures and xenografts was performed. Genomic (CytoScan HD, Affymetrix) and transcriptomic profiles (HTA 2.0 platform, Affymetrix) for VSCC, cell cultures, and xenografts were assessed. P5 cells were able to migrate, invade the Matrigel, and produce tumors in immunodeficient mice, demonstrating their malignant potential. The xenografts unexpectedly presented a sarcomatoid-like carcinoma phenotype. Genomic analysis revealed a high similarity between the VSCC and tumor-derived xenograft, confirming its xenograft origin. Interestingly, a subpopulation of P5 cells presented stem cell-related markers (CD44(+)CD24(-) and ALDH1(high)) and sphere-forming capacity, suggesting their potential xenograft origin. Cell cultures and xenografts retained the genomic alterations present in the parental tumor. Compared to VSCC, differentially expressed transcripts detected in all experimental conditions were associated with cellular morphology, movement, and metabolism and organization pathways. Malignant cell cultures and xenografts derived from a verrucous penile carcinoma were established and fully characterized. Nevertheless, xenograft PeCa models must be used with caution, taking into consideration the selection of specific cell populations and anatomical sites for cell/tumor implantation.
Collapse
|
31
|
La-Touche S, Lemetre C, Lambros M, Stankiewicz E, Ng CKY, Weigelt B, Rajab R, Tinwell B, Corbishley C, Watkin N, Berney D, Reis-Filho JS. DNA Copy Number Aberrations, and Human Papillomavirus Status in Penile Carcinoma. Clinico-Pathological Correlations and Potential Driver Genes. PLoS One 2016; 11:e0146740. [PMID: 26901676 PMCID: PMC4763861 DOI: 10.1371/journal.pone.0146740] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 12/21/2015] [Indexed: 12/11/2022] Open
Abstract
Penile squamous cell carcinoma is a rare disease, in which somatic genetic aberrations have yet to be characterized. We hypothesized that gene copy aberrations might correlate with human papillomavirus status and clinico-pathological features. We sought to determine the spectrum of gene copy number aberrations in a large series of PSCCs and to define their correlations with human papillomavirus, histopathological subtype, and tumor grade, stage and lymph node status. Seventy formalin-fixed, paraffin embedded penile squamous cell carcinomas were centrally reviewed by expert uropathologists. DNA was extracted from micro-dissected samples, subjected to PCR-based human papillomavirus assessment and genotyping (INNO-LiPA human papillomavirus Genotyping Extra Assay) and microarray-based comparative genomic hybridization using a 32K Bacterial Artificial Chromosome array platform. Sixty-four samples yielded interpretable results. Recurrent gains were observed in chromosomes 1p13.3-q44 (88%), 3p12.3-q29 (86%), 5p15.33-p11 (67%) and 8p12-q24.3 (84%). Amplifications of 5p15.33-p11 and 11p14.1-p12 were found in seven (11%) and four (6%) cases, respectively. Losses were observed in chromosomes 2q33-q37.3 (86%), 3p26.3-q11.1 (83%) and 11q12.2-q25 (81%). Although many losses and gains were similar throughout the cohort, there were small significant differences observed at specific loci, between human papillomavirus positive and negative tumors, between tumor types, and tumor grade and nodal status. These results demonstrate that despite the diversity of genetic aberrations in penile squamous cell carcinomas, there are significant correlations between the clinico-pathological data and the genetic changes that may play a role in disease natural history and progression and highlight potential driver genes, which may feature in molecular pathways for existing therapeutic agents.
Collapse
Affiliation(s)
- Susannah La-Touche
- Bart's Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, Charterhouse square, London, United Kingdom
- * E-mail:
| | - Christophe Lemetre
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Maryou Lambros
- Molecular Pathology, Institute of Cancer Research, London, United Kingdom
| | - Elzbieta Stankiewicz
- Bart's Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, Charterhouse square, London, United Kingdom
| | - Charlotte K. Y. Ng
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| | - Ramzi Rajab
- St George’s Hospital, Tooting, London, United Kingdom
| | | | | | - Nick Watkin
- St George’s Hospital, Tooting, London, United Kingdom
| | - Dan Berney
- Bart's Cancer Institute, Centre for Molecular Oncology, Queen Mary University of London, John Vane Science Centre, Charterhouse square, London, United Kingdom
| | - Jorge S. Reis-Filho
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America
| |
Collapse
|
32
|
Chaux A. Reply: To PMID 26188121. Urology 2015; 86:796-7. [PMID: 26329327 DOI: 10.1016/j.urology.2015.03.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Alcides Chaux
- Department of Scientific Research, Norte University, Asunción, Paraguay; Center for the Development of Scientific Research, Asunción, Paraguay
| |
Collapse
|
33
|
Ferrándiz-Pulido C, Hernández-Losa J, Masferrer E, Vivancos A, Somoza R, Marés R, Valverde C, Salvador C, Placer J, Morote J, Pujol RM, Ramon y Cajal S, de Torres I, Toll A, García-Patos V. Identification of somatic gene mutations in penile squamous cell carcinoma. Genes Chromosomes Cancer 2015. [PMID: 26216163 DOI: 10.1002/gcc.22274] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
There is a lack of studies on somatic gene mutations and cell signaling driving penile carcinogenesis. Our objective was to analyze somatic mutations in genes downstream of EGFR in penile squamous cell carcinomas, especially the mTOR and RAS/MAPK pathways. We retrospectively analyzed somatic mutations in 10 in situ and 65 invasive penile squamous cell carcinomas by using Sequenom's Mass Spectrometry iPlex Technology and Oncocarta v1.0 Panel. The DNA was extracted from FFPE blocks and we identified somatic missense mutations in three in situ tumors and in 19 invasive tumors, mostly in PIK3CA, KRAS, HRAS, NRAS, and PDGFA genes. Somatic mutations in the PIK3CA gene or RAS family genes were neither associated with tumor grade, stage or outcome, and were equally often identified in hrHPV positive and in hrHPV negative tumors that showed no p53 expression. Mutations in PIK3CA, KRAS, and HRAS are frequent in penile squamous cell carcinoma and likely play a role in the development of p53-negative tumors. Although the presence of these mutations does not seem to correlate with tumoral behavior or outcome, they could be biomarkers of treatment failure with anti-EGFR mAb in patients with penile squamous cell carcinoma.
Collapse
Affiliation(s)
- Carla Ferrándiz-Pulido
- Dermatology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain.,Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
| | - Javier Hernández-Losa
- Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain.,Pathology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Emili Masferrer
- Dermatology Department, Hospital Del Mar-IMIM, Barcelona, Spain.,Faculty of Medicine, Universitat De Barcelona, Barcelona, Spain
| | - Ana Vivancos
- Vall D'Hebron Institute of Oncology, Barcelona, Spain
| | - Rosa Somoza
- Pathology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Roso Marés
- Pathology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Claudia Valverde
- Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain.,Oncology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Carlos Salvador
- Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain.,Urology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Jose Placer
- Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain.,Urology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Juan Morote
- Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain.,Urology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Ramon M Pujol
- Dermatology Department, Hospital Del Mar-IMIM, Barcelona, Spain.,Faculty of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Ines de Torres
- Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain.,Pathology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain
| | - Agusti Toll
- Dermatology Department, Hospital Del Mar-IMIM, Barcelona, Spain.,Faculty of Medicine, Universitat Pompeu Fabra, Barcelona, Spain
| | - Vicente García-Patos
- Dermatology Department, Hospital Universitari Vall D'hebron, Barcelona, Spain.,Faculty of Medicine, Universitat Autònoma De Barcelona, Barcelona, Spain
| |
Collapse
|
34
|
Chaux A. Risk Group Systems for Penile Cancer Management: A Study of 203 Patients With Invasive Squamous Cell Carcinoma. Urology 2015; 86:790-6. [PMID: 26188121 DOI: 10.1016/j.urology.2015.03.050] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 02/18/2015] [Accepted: 03/06/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To evaluate the accuracy of previously published risk group systems for predicting inguinal nodal metastases in patients with penile carcinoma. MATERIALS AND METHODS Two hundred three cases of invasive penile squamous cell carcinomas (SCC) were stratified using the following systems: Solsona et al (J Urol 2001;165:1509), Hungerhuber et al (Urology 2006;68:621), and the system proposed by the European Association of Urology (EAU; Eur Urol 2004;46:1). Receiver operating characteristic (ROC) analysis was carried out to compare accuracy in predicting final nodal status and cancer-related death. RESULTS Most of cases were pT2/pT3 high-grade tumors with a small percentage of low-grade pT1 carcinomas. The metastatic rates for the Solsona et al, EAU, and Hungerhuber et al systems in the high-risk category were 15 of 73 (21%), 16 of 103 (16%), and 10 of 35 (29%) in patients with clinically negative inguinal lymph nodes and 52 of 75 (69%), 55 of 93 (59%), and 34 of 47 (72%) in patients with palpable inguinal lymph nodes, respectively. Performance by ROC analysis showed a low accuracy for all stratification systems although the Solsona et al and the Hungerhuber et al systems performed better than the EAU system. Patients in intermediate-risk categories and with clinically palpable inguinal lymph nodes were more likely to have nodal metastasis than patients with clinically negative lymph nodes in the same category. CONCLUSION These stratification systems may be useful for patients with low-grade superficial tumors and less accurate for evaluating patients with high-grade locally advanced penile carcinomas. These data may be useful for therapeutic planning of patients with penile SCC.
Collapse
Affiliation(s)
- Alcides Chaux
- Department of Scientific Research, Norte University, Asunción, Paraguay; Center for the Development of Scientific Research, Asunción, Paraguay.
| |
Collapse
|
35
|
Downes MR. Review of in situ and invasive penile squamous cell carcinoma and associated non-neoplastic dermatological conditions. J Clin Pathol 2015; 68:333-40. [PMID: 25883161 DOI: 10.1136/jclinpath-2015-202911] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Penile carcinoma is a rare genitourinary malignancy in North America and Europe with highest rates recorded in South America, Africa and Asia. Recent classifications have refined the terminology used in classifying intraepithelial/in situ lesions and additionally newer entities have been recognised in the invasive category. While increasing recognition of a bimodal pathway of penile carcinogenesis has facilitated understanding and classification of these tumours, handling and subtyping of penile malignancies presents a challenge to the reporting pathologist, in part due to their rarity. This article reviews the terminology and classification of in situ and invasive carcinomas and their relationship to human papilloma virus status. In addition, associated non-neoplastic dermatological conditions of relevance and appropriate ancillary investigations will be addressed.
Collapse
|
36
|
Chaux A. Clinicopathologic and outcome features of superficial high-grade and deep low-grade squamous cell carcinomas of the penis. SPRINGERPLUS 2015; 4:248. [PMID: 26090299 PMCID: PMC4467594 DOI: 10.1186/s40064-015-1035-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/12/2015] [Indexed: 11/29/2022]
Abstract
Purpose To report the clinicopathologic and outcome features of superficial high-grade and deep low-grade penile squamous cell carcinomas. Methods From a retrospectively-collected series of patients with penile cancer we identified 41 cases corresponding to 12 superficial high-grade tumors and 29 deep low-grade tumors. As outcomes we evaluated inguinal lymph node status, presence of tumor relapse, final nodal status, and cancer-specific death. Follow-up ranged from 0.8 to 386.7 months (mean 152.5 months, median 157.3 months). Results Clinicopathologic features were similar between superficial high-grade and deep low-grade tumors, except for a tendency (Fisher’s exact \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$P=0.057$$\end{document}P=0.057) of the former to include tumors with a verruciform pattern of growth. A significantly higher proportion of inguinal lymph node metastasis was found in superficial high-grade tumors compared to deep low-grade tumors [4/5 (80%) vs. 1/5 (20%) respectively, Fisher’s exact \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$P=0.02$$\end{document}P=0.02]. No significant differences were found regarding tumor relapse (Fisher’s exact \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$P=0.52$$\end{document}P=0.52), final nodal status (Mantel-Cox’s \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$P=0.42$$\end{document}P=0.42), or cancer-related death (Mantel-Cox’s \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{mathrsfs}
\usepackage{upgreek}
\setlength{\oddsidemargin}{-69pt}
\begin{document}$$P=0.52$$\end{document}P=0.52). Conclusions Patients with superficial high-grade tumors had a significantly higher proportion of inguinal lymph node metastasis compared to patients with deep low-grade tumors. On this regard, prophylactic inguinal lymphadenectomy might be indicated in cases of superficial tumors with high-grade histology while in deeply invasive low-grade penile carcinomas a more conservative approach may be considered.
Collapse
Affiliation(s)
- Alcides Chaux
- Department of Scientific Research, Norte University, Gral. Santos e/25 de Mayo, Asunción, Paraguay ; Centro para el Desarrollo de la Investigación Científica, Asunción, Paraguay
| |
Collapse
|
37
|
Sanchez DF, Cañete S, Fernández-Nestosa MJ, Lezcano C, Rodríguez I, Barreto J, Alvarado-Cabrero I, Cubilla AL. HPV- and non-HPV-related subtypes of penile squamous cell carcinoma (SCC): Morphological features and differential diagnosis according to the new WHO classification (2015). Semin Diagn Pathol 2015; 32:198-221. [DOI: 10.1053/j.semdp.2014.12.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
|
38
|
Sanchez DF, Soares F, Alvarado-Cabrero I, Cañete S, Fernández-Nestosa MJ, Rodríguez IM, Barreto J, Cubilla AL. Pathological factors, behavior, and histological prognostic risk groups in subtypes of penile squamous cell carcinomas (SCC). Semin Diagn Pathol 2015; 32:222-31. [DOI: 10.1053/j.semdp.2014.12.017] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
39
|
Steinestel J, Al Ghazal A, Arndt A, Schnoeller TJ, Schrader AJ, Moeller P, Steinestel K. The role of histologic subtype, p16(INK4a) expression, and presence of human papillomavirus DNA in penile squamous cell carcinoma. BMC Cancer 2015; 15:220. [PMID: 25885064 PMCID: PMC4392470 DOI: 10.1186/s12885-015-1268-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Accepted: 03/25/2015] [Indexed: 12/22/2022] Open
Abstract
Background Up to 50% of penile squamous cell carcinomas (pSCC) develop in the context of high-risk human papillomavirus (HR-HPV) infection. Most of these tumours have been reported to show basaloid differentiation and overexpression of tumour suppressor protein p16INK4a. Whether HPV-triggered carcinogenesis in pSCC has an impact on tumour aggressiveness, however, is still subject to research. Methods In tissue specimens from 58 patients with surgically treated pSCC between 1995 and 2012, we performed p16INK4a immunohistochemistry and DNA extraction followed by HPV subtyping using a PCR-based approach. The results were correlated with histopathological and clinical parameters. Results 90.4% of tumours were of conventional (keratinizing) subtype. HR-HPV DNA was detected in 29.3%, and a variety of p16INK4a staining patterns was observed in 58.6% of samples regardless of histologic subtype. Sensitivity of basaloid subtype to predict HR-HPV positivity was poor (11.8%). In contrast, sensitivity and specificity of p16INK4a staining to predict presence of HR-HPV DNA was 100% and 57%, respectively. By focussing on those samples with intense nuclear staining pattern for p16INK4a, specificity could be improved to 83%. Both expression of p16INK4a and presence of HR-HPV DNA, but not histologic grade, were inversely associated with pSCC tumour invasion (p = 0.01, p = 0.03, and p = 0.71). However, none of these correlated with nodal involvement or distant metastasis. In contrast to pathological tumour stage, the HR-HPV status, histologic grade, and p16INK4a positivity failed to predict cancer-specific survival. Conclusions Our results confirm intense nuclear positivity for p16INK4a, rather than histologic subtype, as a good predictor for presence of HR-HPV DNA in pSCC. HR-HPV / p16INK4a positivity, independent of histological tumour grade, indicates a less aggressive local behaviour; however, its value as an independent prognostic indicator remains to be determined. Since local invasion can be judged without p16INK4a/HPV-detection on microscopic evaluation, our study argues against routine testing in the setting of pSCC.
Collapse
Affiliation(s)
- Julie Steinestel
- Department of Urology, Muenster University Medical Center, Albert-Schweitzer-Campus 1, A1, 48149, Muenster, Germany.
| | - Andreas Al Ghazal
- Department of Urology, University of Ulm, Prittwitzstrasse 43, 89075, Ulm, Germany.
| | - Annette Arndt
- Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany.
| | - Thomas J Schnoeller
- Department of Urology, University of Ulm, Prittwitzstrasse 43, 89075, Ulm, Germany.
| | - Andres J Schrader
- Department of Urology, Muenster University Medical Center, Albert-Schweitzer-Campus 1, A1, 48149, Muenster, Germany.
| | - Peter Moeller
- Institute of Pathology, University of Ulm, Albert-Einstein-Allee 23, 89070, Ulm, Germany.
| | - Konrad Steinestel
- Gerhard Domagk Institute of Pathology, University of Muenster, Domagkstrasse 17, 48149, Muenster, Germany.
| |
Collapse
|
40
|
Human papillomavirus infection and immunohistochemical p16INK4a expression as predictors of outcome in penile squamous cell carcinomas. Hum Pathol 2015; 46:532-40. [DOI: 10.1016/j.humpath.2014.12.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 12/08/2014] [Accepted: 12/17/2014] [Indexed: 11/20/2022]
|
41
|
Do preoperative serum C-reactive protein levels predict the definitive pathological stage in patients with clinically localized prostate cancer? Int Urol Nephrol 2015; 47:765-70. [DOI: 10.1007/s11255-015-0952-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 03/09/2015] [Indexed: 12/14/2022]
|
42
|
Faraj SF, Chaux A, Gonzalez-Roibon N, Munari E, Cubilla AL, Shih IM, Netto GJ. Immunohistochemical expression of ARID1A in penile squamous cell carcinomas: a tissue microarray study of 112 cases. Hum Pathol 2015; 46:761-6. [PMID: 25776029 DOI: 10.1016/j.humpath.2015.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 01/28/2015] [Accepted: 01/30/2015] [Indexed: 01/26/2023]
Abstract
ARID1A, a member of the chromatin remodeling genes family, has been suggested as a novel tumor suppressor gene in gynecologic malignancies. However, its role in penile cancer has yet to be determined. This study assesses the immunohistochemical expression of ARID1A in penile squamous cell carcinoma (SCC) and its association with pathologic features, human papillomavirus (HPV) status, and previously reported mammalian target of rapamycin pathway markers in the same cohort. Four tissue microarrays were constructed from 112 cases of formalin-fixed, paraffin-embedded penile SCC from Paraguay. Each tumor was sampled 3 to 12 times. ARID1A expression was evaluated by immunohistochemistry using a polyclonal rabbit anti-ARID1A (BAF250A) antibody. An H score was calculated in each spot as the sum of expression intensity (0-3+) by extent (0%-100%). Median H score per case was used for statistical analysis. ARID1A expression was observed in all cases, ranging from 3% to 100% of tumor cells (median, 95%). In 96 cases (86%), ARID1A expression was observed in 90% or more tumor cells. HPV DNA was detected in 20 (38%) of 52 analyzed samples. There was a significant trend of association between ARID1A and histologic grade. ARID1A expression was not associated with histologic subtype (P = .61) or HPV status (P = .18). ARID1A expression decreased with decreasing levels of PTEN expression (P = .01). ARID1A was expressed in penile SCC, in most cases at high levels. A significant trend of association was found between histologic grade and ARID1A expression, with lower ARID1A expression, lower histologic grades, and decreased PTEN expression.
Collapse
Affiliation(s)
- Sheila F Faraj
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 31231
| | - Alcides Chaux
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 31231; Department of Scientific Research, Norte University, Asunción, 1614, Paraguay.
| | | | - Enrico Munari
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 31231
| | | | - Ie-Ming Shih
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 31231
| | - George J Netto
- Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 31231; Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD 31231; Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD 31231
| |
Collapse
|
43
|
Li F, Xu Y, Wang H, Chen BO, Wang Z, Zhao Y, Zhu S, Chen G. Diagnosis and treatment of penile verrucous carcinoma. Oncol Lett 2015; 9:1687-1690. [PMID: 25789024 PMCID: PMC4356329 DOI: 10.3892/ol.2015.2909] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 11/21/2014] [Indexed: 11/10/2022] Open
Abstract
Penile verrucous carcinoma is an extremely rare disease that, at present, has not been well characterized. The etiology, diagnosis and treatment of this carcinoma remain poorly understood, particularly in the Chinese population. The aim of the present study was to discuss the methods of diagnosis and treatment of penile verrucous carcinoma in the Chinese population. The clinical and pathological data of 10 patients with penile verrucous carcinoma were analyzed alongside a literature review. All the tumors were exophytic papillary lesions, ranging between 0.4 and 4 cm in diameter and all 10 patients underwent partial penectomy with tumor-negative surgical margins. None of the 10 patients underwent ilioinguinal lymphadenectomy. All patients were regularly followed up for 0.7–9 years, which revealed that no patients developed recurrence, and only one case resulted in mortality due to unassociated causes. It was found that penile verrucous carcinoma is a well-differentiated disease with low malignant potential and locally aggressive features, which seldom metastasizes to regional lymph nodes or distant regions. However, misdiagnosis may occur due to an incorrect biopsy. Favorable outcomes can be achieved by surgery, even without any adjuvant therapy, but patients should be carefully followed up.
Collapse
Affiliation(s)
- Fangyin Li
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Yipeng Xu
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Hua Wang
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - B O Chen
- Department of Pathology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Zongping Wang
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Yang Zhao
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Shaoxing Zhu
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| | - Guiping Chen
- Department of Urology, Zhejiang Cancer Hospital, Hangzhou, Zhejiang 310022, P.R. China
| |
Collapse
|
44
|
Muñoz JJ, Drigo SA, Barros-Filho MC, Marchi FA, Scapulatempo-Neto C, Pessoa GS, Guimarães GC, Trindade Filho JCS, Lopes A, Arruda MAZ, Rogatto SR. Down-Regulation of SLC8A1 as a Putative Apoptosis Evasion Mechanism by Modulation of Calcium Levels in Penile Carcinoma. J Urol 2014; 194:245-51. [PMID: 25481039 DOI: 10.1016/j.juro.2014.11.097] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE The SLC8A1 gene, which encodes the Na(+)/Ca(2+) exchanger, has a key role in calcium homeostasis. Our previous gene expression oligoarray data revealed SLC8A1 under expression in penile carcinoma. We investigated whether dysregulation of SLC8A1 expression is associated with apoptosis and cell proliferation in penile carcinoma via modulation of the calcium concentration. The underlying mechanisms of SLC8A1 under expression were also explored, focusing on copy number alteration and miRNA. MATERIALS AND METHODS Transcript levels of the SLC8A1 gene and miR-223 were evaluated by quantitative polymerase chain reaction to compare penile carcinoma samples with normal glans tissue. SLC8A1 copy number was evaluated by microarray based comparative genomic hybridization. In normal and tumor samples we investigated caspase-3 and Ki-67 immunostaining as well as calcium distribution by laser ablation imaging inductively coupled plasma mass spectrometry. RESULTS SLC8A1 under expression was detected in penile carcinoma samples (p = 0.001), confirming our previous data. It was not associated with gene copy number loss. In contrast, miR-223 over expression (p = 0.002) inversely correlated with its putative repressor SLC8A1 (r = -0.426, p = 0.015). SLC8A1 under expression was associated with decreased calcium distribution, high Ki-67 and low caspase-3 immunoexpression in penile carcinoma compared to normal tissue. CONCLUSIONS Down-regulation of the SLC8A1 gene, most likely mediated by its regulator miR-223, can lead to decreased calcium in penile carcinoma and consequently to suppressed apoptosis and increased tumor cell proliferation. These data suggest that the miR-223-NCX1-calcium signaling axis may represent a potential therapeutic approach to penile carcinoma.
Collapse
Affiliation(s)
- Juan J Muñoz
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Sandra A Drigo
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Mateus C Barros-Filho
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Fábio A Marchi
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Cristovam Scapulatempo-Neto
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Gustavo S Pessoa
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Gustavo C Guimarães
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - José Carlos S Trindade Filho
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Ademar Lopes
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Marco A Z Arruda
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil
| | - Silvia R Rogatto
- International Research Center (JJM, MCB-F, FAM, SRR), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pelvic Surgery (AL), A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Pathology, Barretos Cancer Hospital (CS-N), São Paulo, Brazil; Department of Genetics, Institute of Biosciences (JJM), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Department of Urology, Faculty of Medicine (SAD, JCSTF, SRR), São Paulo State University-Universidade Estadual Paulista, Botucatu, Brazil; Group of Spectrometry, Sample Preparation and Mechanization (GSP, MAZA), Institute of Chemistry, State University of Campinas, Campinas, Brazil; National Institute of Science and Technology for Bioanalytics, Institute of Chemistry, State University of Campinas, Campinas, Brazil.
| |
Collapse
|
45
|
Le carcinome épidermoïde du pénis: évaluation clinique et thérapeutique de la tumeur primitive. ONCOLOGIE 2014. [DOI: 10.1007/s10269-014-2380-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
46
|
Chaux A, Munari E, Cubilla AL, Hicks J, Lecksell K, Burnett AL, Netto GJ. Immunohistochemical expression of the mammalian target of rapamycin pathway in penile squamous cell carcinomas: a tissue microarray study of 112 cases. Histopathology 2014; 64:863-71. [DOI: 10.1111/his.12338] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Accepted: 11/25/2013] [Indexed: 12/27/2022]
Affiliation(s)
- Alcides Chaux
- Department of Pathology; Johns Hopkins Medical Institutions; Baltimore MD USA
- Office of Scientific Research; Norte University; Asunción Paraguay
| | - Enrico Munari
- Department of Pathology; Johns Hopkins Medical Institutions; Baltimore MD USA
| | | | - Jessica Hicks
- Department of Pathology; Johns Hopkins Medical Institutions; Baltimore MD USA
| | - Kristen Lecksell
- Department of Pathology; Johns Hopkins Medical Institutions; Baltimore MD USA
| | - Arthur L Burnett
- Department of Urology; Johns Hopkins Medical Institutions; Baltimore MD USA
| | - George J Netto
- Department of Pathology; Johns Hopkins Medical Institutions; Baltimore MD USA
- Department of Urology; Johns Hopkins Medical Institutions; Baltimore MD USA
- Department of Oncology; Johns Hopkins Medical Institutions; Baltimore MD USA
| |
Collapse
|
47
|
Gunia S, Koch S, Jain A, May M. Does the width of the surgical margin of safety or premalignant dermatoses at the negative surgical margin affect outcome in surgically treated penile cancer? J Clin Pathol 2013; 67:268-71. [PMID: 24100380 DOI: 10.1136/jclinpath-2013-201911] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To evaluate the prognostic impact of the width of negative surgical margins (NSM) and associated and preinvasive lesions at the NSM in patients with penile squamous cell cancer (PSC). METHODS Enrolling 87 patients with NSM who underwent surgery for PSC, the archived margin slides and entirely wax-embedded surgical margins were retrieved from the pathology files. After step sections were cut, margins were stained with antibodies against CK5/6, p16, p53 and Ki-67 and subjected to in situ hybridisation for high-risk human papillomavirus (HPV). All NSM were histologically examined for squamous hyperplasia (SH), lichen sclerosus (LS) and subtypes of penile intraepithelial neoplasia (PeIN). Then, histological findings were correlated with cancer-specific mortality (CSM, median follow-up 34 months; IQR 6-70). RESULTS All NSM were negative for high-risk HPV and exhibited SH (p16 and p53 negative, Ki-67 variably positive), LS (p16 negative, variable p53 and Ki-67 positivity) and differentiated PeIN (dPeIN; p16 negative, Ki-67 positive, variable p53 positivity) in 28 (32%), 30 (34%) and 22 (25%) cases, respectively, whereas PeIN subtypes other then dPeIN did not occur. Pathological tumour stage was the only independent predictive parameter with respect to CSM in the multivariable analysis (p=0.001). CONCLUSIONS SH, LS and dPeIN are frequent histological findings at the NSM of surgically treated PSC. However, neither the width of the NSM nor dPeIN, LS or SH at the NSM influences prognostic outcome.
Collapse
Affiliation(s)
- Sven Gunia
- Institutes of Pathology at the Johanniter Hospital Stendal, , Stendal, Germany
| | | | | | | |
Collapse
|
48
|
Ebel JJ, Shabsigh A, Sharp DS, Zynger DL. Whole-mount evaluation of penectomies for penile cancer: feasibility, cost and comparison to routine sectioning. Histopathology 2013; 63:64-73. [PMID: 23738630 DOI: 10.1111/his.12149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/25/2013] [Indexed: 11/28/2022]
Abstract
AIMS Pathological staging in penectomies may be difficult due to the anatomical complexity of penile anatomy, and may be additionally challenging due to the low volume at most institutions. Our study aimed to assess the feasibility of whole-mount processing for penectomy specimens. METHODS AND RESULTS A 7-year retrospective search for partial or radical penectomies identified 55 specimens, which were processed routinely (n = 31) from 2006 to 2009 and whole-mounted (n = 24) from 2010 to 2012. Routine cases used more slides per case compared to whole mounts (mean 10.4 versus 7.2). Recuts occurred more often in routine cases (12.9% versus 0%). More routine cases had additional blocks grossed (19.4% versus 4.2%). Upon review, five discrepancies that impacted pT staging were identified in the routine group, with none in the whole-mount group. The average estimated additional cost for each whole-mount case compared to routine processing was $40.74, with an increased turnaround time of 1 day. CONCLUSIONS Whole-mounting is a feasible technique for penectomy that can be utilized with minimal increased cost and turnaround time, and may improve staging. Institutions in which whole-mounting is already established for other organs, such as prostate, may wish to consider utilizing this format for penectomy specimens.
Collapse
Affiliation(s)
- Joshua J Ebel
- Department of Pathology, The Ohio State University Medical Center, Columbus, OH 43210, USA
| | | | | | | |
Collapse
|
49
|
Steffens S, Al Ghazal A, Steinestel J, Lehmann R, Wegener G, Schnoeller TJ, Cronauer MV, Jentzmik F, Schrader M, Kuczyk MA, Schrader AJ. High CRP values predict poor survival in patients with penile cancer. BMC Cancer 2013; 13:223. [PMID: 23642165 PMCID: PMC3649950 DOI: 10.1186/1471-2407-13-223] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 04/25/2013] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND High levels of circulating C-reactive protein (CRP) have recently been linked to poor clinical outcome in various malignancies. The aim of this study was to evaluate the prognostic significance of the preoperative serum CRP level in patients with squamous cell carcinoma (SCC) of the penis. METHODS This retrospective analysis included 79 penile cancer patients with information about their serum CRP value prior to surgery who underwent either radical or partial penectomy at two German high-volume centers (Ulm University Medical Center and Hannover Medical School) between 1990 and 2010. They had a median (mean) follow-up of 23 (32) months. RESULTS A significantly elevated CRP level (>15 vs. ≤ 15 mg/l) was found more often in patients with an advanced tumor stage (≥pT2) (38.9 vs. 11.6%, p=0.007) and in those with nodal disease at diagnosis (50.0 vs. 14.6%, p=0.007). However, high CRP levels were not associated with tumor differentiation (p=0.53). The Kaplan-Meier 5-year cancer-specific survival (CSS) rate was 38.9% for patients with preoperative CRP levels above 15 mg/l and 84.3% for those with lower levels (p=0.001). Applying multivariate analysis and focusing on the subgroup of patients without metastasis at the time of penile surgery, both advanced local tumor stage (≥pT2; HR 8.8, p=0.041) and an elevated CRP value (>15 mg/l; HR 3.3, p=0.043) were identified as independent predictors of poor clinical outcome in patients with penile cancer. CONCLUSIONS A high preoperative serum CRP level was associated with poor survival in patients with penile cancer. If larger patient populations confirm its prognostic value, its routine use could enable better risk stratification and risk-adjusted follow-up of patients with SCC of the penis.
Collapse
Affiliation(s)
- Sandra Steffens
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Andreas Al Ghazal
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| | - Julie Steinestel
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| | - Rieke Lehmann
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Gerd Wegener
- Cancer Center, Hannover Medical School, Hannover, Germany
| | - Thomas J Schnoeller
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| | - Marcus V Cronauer
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| | - Florian Jentzmik
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| | - Mark Schrader
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| | - Markus A Kuczyk
- Department of Urology, Hannover Medical School, Hannover, Germany
| | - Andres J Schrader
- Department of Urology, Ulm University Medical Center, Pritzwitzstrasse 43, Ulm, D-89075, Germany
| |
Collapse
|
50
|
Annunziata C, Buonaguro L, Losito S, Buonaguro FM, Tornesello ML. Somatic mutations of STK11 gene in human papillomavirus positive and negative penile cancer. Infect Agent Cancer 2013; 8:2. [PMID: 23305393 PMCID: PMC3584742 DOI: 10.1186/1750-9378-8-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/07/2013] [Indexed: 12/14/2022] Open
Abstract
Background Human papillomavirus (HPV) infection accounts for about 40-50% of all cases of penile carcinoma suggesting that other factors, including host genetic status, are involved in neoplastic transformation. In this perspective, STK11 gene, which has been found frequently mutated in HPV-related cervical carcinoma, has been analyzed in HPV-positive and HPV-negative invasive penile cancers to establish its mutational status and the possible correlation of HPV infection with specific genetic alterations. Methods Genomic DNAs extracted from 26 cases of penile squamous cell carcinoma were analyzed for genetic alterations in the exons 1 to 9 of STK11 gene by quantitative real-time PCR. Ratios of potentially deleted and non-deleted exons were indicative of specific loss of STK11 coding regions. DNA samples of 5 cancer cases were subjected to standard PCR amplification of STK11 exons 1 to 9 and analyzed for somatic mutations by direct nucleotide sequencing analysis. Results Heterozygous deletions of STK11 exon 1 and 2 were identified in 2 out of 14 HPV-positive (14.3%) and 1 out of 12 HPV-negative cases (8.3%). Complete nucleotide sequencing analysis of exons 1 to 9 showed a single nucleotide change upstream the exon 2 coding region in 1 out of 5 penile carcinoma samples. Conclusions The present results suggest that single nucleotide mutations and/or deletions of STK11 gene are rare events in penile cancer. Moreover, no significant association was observed between STK11 alterations and HPV infection in these tumors.
Collapse
Affiliation(s)
- Clorinda Annunziata
- Molecular Biology and Viral Oncology, National Cancer Institute "Fond, Pascale", Cappella Cangiani, 80131, Naples, Italy.
| | | | | | | | | |
Collapse
|