1
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Pinho JD, Silva GEB, Teixeira-Júnior AAL, Rocha TMS, Batista LL, de Sousa AM, Calixto JDRR, Burbano RR, de Souza CRT, Khayat AS. Non-Coding RNA in Penile Cancer. Front Oncol 2022; 12:812008. [PMID: 35651809 PMCID: PMC9150447 DOI: 10.3389/fonc.2022.812008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/11/2022] [Indexed: 11/25/2022] Open
Abstract
Penile cancer (PC) still presents a health threat for developing countries, in particular Brazil. Despite this, little progress has been made on the study of markers, including molecular ones, that can aid in the correct management of the patient, especially concerning lymphadenectomy. As in other neoplasms, non-coding RNAs (ncRNAs) have been investigated for penile cancer, with emphasis on microRNAs, piRNAs (PIWI-interacting small RNAs), and long non-coding RNAs (LncRNAs). In this context, this review aims to assemble the available knowledge on non-coding RNA linked in PC, contributing to our understanding of the penile carcinogenesis process and addressing their clinical relevance. ncRNAs are part of the novel generation of biomarkers, with high potential for diagnosis and prognosis, orientating the type of treatment. Furthermore, its versatility regarding the use of paraffin samples makes it possible to carry out retrospective studies.
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Affiliation(s)
- Jaqueline Diniz Pinho
- Zé Doca Center for Higher Studies, State University of Maranhão, Zé Doca, Brazil
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
- Oncology Research Center, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- *Correspondence: Jaqueline Diniz Pinho,
| | - Gyl Eanes Barros Silva
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Antonio Augusto Lima Teixeira-Júnior
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
- Department of Genetics, University of Sao Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thalita Moura Silva Rocha
- Laboratory of Immunofluorescence and Electron Microscopy, University Hospital of the Federal University of Maranhão, São Luís, Brazil
| | - Lecildo Lira Batista
- Oncology Research Center, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
- Coordination of Medicine, Federal University of Amapá, Macapá, Brazil
| | - Amanda Marques de Sousa
- Oncology Research Center, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
| | | | | | | | - André Salim Khayat
- Oncology Research Center, João de Barros Barreto University Hospital, Federal University of Pará, Belém, Brazil
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2
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Dos Santos J, Cabrebra R, Neves B, Silva E, Polónia A. Squamous cell carcinoma with sarcomatous transformation of the penis. AUTOPSY AND CASE REPORTS 2021; 11:e2021303. [PMID: 34458171 PMCID: PMC8387073 DOI: 10.4322/acr.2021.303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/05/2021] [Indexed: 11/26/2022] Open
Abstract
Malignant tumors of the penis are rare, most of them being squamous cell carcinomas (SCCs). We report the case of a 75-year-old man with a large penile mass submitted to partial penectomy. The specimen showed an exophytic mass involving the glans, coronal sulcus, and prepuce. Microscopic examination showed a carcinoma with two distinct areas: a mixed SCC and a sarcomatoid carcinoma. The SCC component had areas of verrucous carcinoma and areas of classical invasive SCC. The tumor cells expressed p63 with the absence of p16 expression. Vimentin and p53 were positive in the sarcomatous component. The morphology and immunohistochemistry were compatible with mixed SCC (verrucous hybrid-sarcomatoid carcinoma). Additionally, the tumor cells also expressed 3 different clones of PDL1 (22C3, SP263, and SP142). Two months later, the patient presented local recurrence with multiple lymph nodes and lung metastases, dying 7 weeks later. Mixed tumors represent diagnostic challenges. The correct identification of adverse prognostic factors can be the first step to implement the treatment with a higher probability of success.
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Affiliation(s)
- Joana Dos Santos
- Unidade Local de Saúde de Matosinhos (ULSM), Department of Pathology, Matosinhos, Porto, Portugal
| | - Rafael Cabrebra
- Instituto Português de Oncologia de Lisboa (IPO Lisboa), Department of Pathology, Lisboa, Lisboa, Portugal
| | - Beatriz Neves
- Universidade do Porto (U. Porto), Institute of Molecular Pathology and Immunology (IPATIMUP), Ipatimup Diagnostics, Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), University of Porto, Porto, Porto, Portugal
| | - Eduardo Silva
- Instituto Português de Oncologia de Lisboa (IPO Lisboa), Department of Urology, Lisboa, Lisboa, Portugal
| | - António Polónia
- Universidade do Porto (U. Porto), Institute of Molecular Pathology and Immunology (IPATIMUP), Ipatimup Diagnostics, Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde (I3S), University of Porto, Porto, Porto, Portugal
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3
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Mo M, Tong S, Huang W, Cai Y, Zu X, Hu X. High serum CCL20 is associated with tumor progression in penile cancer. J Cancer 2020; 11:6812-6822. [PMID: 33123272 PMCID: PMC7591991 DOI: 10.7150/jca.48939] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/14/2020] [Indexed: 12/12/2022] Open
Abstract
Serum cancer biomarker has been proven to be very valuable in cancer diagnosis, disease monitoring and prognosis assessment, despite there is still a lack of serum biomarker for penile cancer (PC). Our initial analysis on public GEO dataset identified CCL20 as a top C-C motif ligand (CCL) gene enriched in PC. The patients with PC exhibited markedly higher preoperative serum CCL20 level than healthy control. The area under the curve (AUC) was 0.855 with the sensitivity of 72.4%, and specificity of 93.5% to distinguish PC. Preoperative serum CCL20 level was significantly associated with clinicopathological characteristics including T stage (P=0.005), nodal status (P=0.008), and pelvic lymph node metastasis (P=0.007). PC Patients with high serum CCL20 level had shorter disease-free survival compared to those with low level (P<0.001). Cox regression analysis showed that serum CCL20 level could serve as an independent prognostic factor for disease-free survival with a HR of 3.980 (95% CI: 1.209-13.098, P=0.023). Furthermore, CCL20 expression was observed in PC tissues and cell lines. Knockdown of CCL20 expression markedly suppressed malignant phenotypes (cell proliferation, clonogenesis, apoptosis escape, migration and invasion), attenuated STAT3 and AKT signaling and reduced MMP2/9 secretion in PC cell lines. Consistently, CCL20 and its receptor CCR6 exhibited correlated expression pattern in PC tissues. In conclusion, serum CCL20 level might serve as a potential diagnostic and prognostic cancer biomarker for PC. CCL20 might activate multiple downstream oncogenic signaling pathways (STAT3, AKT, MMP2/9) to promote malignant progression of PC, which may warrant further investigation in the future.
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Affiliation(s)
- Miao Mo
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Shiyu Tong
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Wei Huang
- Xiangya School of Medicine, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yi Cai
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Xiongbing Zu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Xiheng Hu
- Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
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4
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Kamel MH, Khalil MI, Davis R, Spiess PE. Management of the Clinically Negative (cN0) Groin Penile Cancer Patient: A Review. Urology 2019; 131:5-13. [PMID: 31129195 DOI: 10.1016/j.urology.2019.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 05/08/2019] [Accepted: 05/10/2019] [Indexed: 01/05/2023]
Abstract
To determine the role of noninvasive, minimally invasive diagnostic modalities and current management recommendations for cN0 PNC, a literature review using PubMed and Web of Science search engines were conducted. We found that for predicting ILN+: physical exam has limitations, nomograms are not validated, conventional computerized tomography/magnetic resonance imaging/positron imaging tomography scans have minimal role, and dynamic sentinel lymph node biopsy is the most reliable minimally invasive modality. Adverse pathological features: G3, stage ≥ T2, presence of LVI, and rare histopathological variants are important predictors of ILN+ and their presence warrants prophylactic ILND or dynamic sentinel lymph node biopsy. In the absence of these adverse pathological features conservative management is justified.
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Affiliation(s)
- Mohamed H Kamel
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Mahmoud I Khalil
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Rodney Davis
- Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Philippe E Spiess
- Department of Genito-urinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL.
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5
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Chipollini J, Garcia-Castaneda J, Harb-De la Rosa A, Cheriyan S, Azizi M, Spiess PE. Important surgical concepts and techniques in inguinal lymph node dissection. Curr Opin Urol 2019; 29:286-292. [DOI: 10.1097/mou.0000000000000591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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6
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Molecular Basics on Genitourinary Malignancies. Urol Oncol 2019. [DOI: 10.1007/978-3-319-42623-5_45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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7
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Kuasne H, Barros-Filho MC, Marchi FA, Drigo SA, Scapulatempo-Neto C, Faria EF, Rogatto SR. Nuclear loss and cytoplasmic expression of androgen receptor in penile carcinomas: role as a driver event and as a prognosis factor. Virchows Arch 2018; 473:607-614. [PMID: 30099587 DOI: 10.1007/s00428-018-2404-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 05/12/2018] [Accepted: 06/29/2018] [Indexed: 11/24/2022]
Abstract
Androgen receptor (AR) is a member of the steroid and nuclear family receptor that acts as transcription factor. AR signaling plays pivotal role in the development and progression of prostate cancer. However, the role of AR in penile cancer (PeCa) is poorly explored. Our previous molecular studies unveiled frequent AR mRNA loss in PeCa, which was further predicted as a major driver alteration in this neoplasm. Herein, we assessed the AR protein expression in 59 usual PeCa tissues and 42 surrounding normal tissues (SNT) by immunohistochemistry using a tissue microarray. In a paired analysis, we found a total absence of nuclear AR expression in PeCa while 95.2% of SNT samples presented strong nuclear AR expression (P < 0.001). Interestingly, 17 of 42 PeCa presented weak or moderate cytoplasmic AR staining, contrasting with 5 of 42 SNT (P = 0.008). Increased levels of AR cytoplasmic expression were related with poor prognosis features including advanced clinical staging (P = 0.044), compromised surgical margins (P = 0.005), and pathological inguinal node status (P = 0.047). Furthermore, AR cytoplasmic expression was also related with shorter overall survival (P = 0.032). In conclusion, the frequent loss of nuclear AR protein levels suggests a potential function in PeCa development. Based on this result, the androgen deprivation therapy is not indicated for PeCa patients. In addition, the AR cytoplasmic expression found in a significant number of cases (40.5%) showed prognostic value and pathways activated by the non-genomic AR signaling may represent a promising therapeutic strategy.
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Affiliation(s)
- Hellen Kuasne
- Department of Urology, Faculty of Medicine, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil.,CIPE - A.C. Camargo Cancer Center, São Paulo, Brazil
| | | | | | - Sandra A Drigo
- Department of Surgery and Orthopedics and Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, UNESP, Botucatu, São Paulo, Brazil
| | - Cristovam Scapulatempo-Neto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos and Diagnósticos da América (DASA), São Paulo, São Paulo, Brazil
| | - Eliney F Faria
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | - Silvia R Rogatto
- Department of Clinical Genetics, Vejle Hospital, Institute of Regional Health Research, University of Southern Denmark, Beriderbakken 4, 7100, Vejle, Denmark.
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8
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Yang C, Li Y, Fu L, Jiang T, Meng F. Betulinic acid induces apoptosis and inhibits metastasis of human renal carcinoma cells in vitro and in vivo. J Cell Biochem 2018; 119:8611-8622. [PMID: 29923216 DOI: 10.1002/jcb.27116] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 05/04/2018] [Indexed: 11/07/2022]
Abstract
Betulinic acid (BA), a natural product with a broad range of biological properties, is a lupane-type pentacyclic triterpene isolated from various plants. Evidence is accumulating that BA is cytotoxic against multiple types of human cancer cells; however, its effects on renal carcinoma cells remain obscure. This study aimed to evaluate the anticancer activity of BA in human renal cancer cells in vitro and in vivo. In the current study, we found that BA inhibited renal cancer cell proliferation in a time-dependent and dose-dependent manner in vitro. Moreover, flow cytometry analysis revealed that BA affected the survival of renal cancer cells via the induction of apoptosis. Western blot analysis showed that the occurrence of apoptosis was associated with upregulation of Bcl2-associated X protein and cleaved caspase-3 and downregulation of B-cell lymphoma 2 in renal cancer cells. Additionally, BA treatment augmented the production of reactive oxygen species and induced a significant loss of mitochondrial membrane potential in renal cancer cells, suggesting that BA may trigger apoptosis via the mitochondria-mediated apoptotic pathway. Furthermore, the migrative and invasive capabilities of renal cancer cells were markedly repressed by BA treatment, which was related to upregulation of matrix metalloproteinase (MMP)2, MMP9, and vimentin, and downregulation of tissue inhibitor of metalloproteinase 2 and E-cadherin. Notably, administration of BA retarded tumor growth in 786-O-bearing mice in vivo. Taken together, our results demonstrated the anticancer potential of BA in human renal cancer cells by triggering apoptosis and suppressing migration and invasion.
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Affiliation(s)
- Chunming Yang
- Department of Urology, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Yan Li
- Department of Biotherapy, Cancer Research Institute, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Liye Fu
- Department of Biotherapy, Cancer Research Institute, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Tao Jiang
- Department of Biotherapy, Cancer Research Institute, The First Affiliated Hospital, China Medical University, Shenyang, China
| | - Fandong Meng
- Department of Biotherapy, Cancer Research Institute, The First Affiliated Hospital, China Medical University, Shenyang, China
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9
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Cheng THT, Lam W, Teoh JYC. Molecular Basics on Genitourinary Malignancies. Urol Oncol 2018. [DOI: 10.1007/978-3-319-42603-7_45-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Zargar-Shoshtari K, Sharma P, Spiess PE. Insight into novel biomarkers in penile cancer: Redefining the present and future treatment paradigm? Urol Oncol 2017; 36:433-439. [PMID: 29103967 DOI: 10.1016/j.urolonc.2017.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Revised: 07/20/2017] [Accepted: 10/10/2017] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Biomarkers are increasingly used in the diagnosis and management of various malignancies. Selected biomarkers may also play a role in management of certain cases of penile carcinoma. In this article, we provide an overview of the clinical role of such markers in the management of penile cancer. METHOD This is a nonsystematic review of relevant literature assessing biomarkers in penile carcinoma. RESULTS Evidence of infections with human papillomavirus and its surrogate markers may have important prognostic value in patients with localized or metastatic penile cancer. Squamous cell carcinoma antigen, p53, C-reactive protein, Ki-67, proliferating cell nuclear antigen, cyclin D1, as well as other markers have been studied with various degree of evidence in support of clinical utility in penile cancer. CONCLUSIONS No single marker may have all the answers, and future research should focus on genomic analysis of individual penile tumors, attempting to identify specific targets for treatment.
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Affiliation(s)
| | - Pranav Sharma
- Department of Urology, Texas Tech Health Sciences Center, Lubbock, TX
| | - Philippe E Spiess
- Departments of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL.
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11
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Chipollini J, Tang DH, Manimala N, Gilbert SM, Pow-Sang JM, Sexton WJ, Poch MA, Spiess PE. Evaluating the accuracy of intraoperative frozen section during inguinal lymph node dissection in penile cancer. Urol Oncol 2017; 36:14.e1-14.e5. [PMID: 29032883 DOI: 10.1016/j.urolonc.2017.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/02/2017] [Accepted: 08/21/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Inguinal lymph node dissection is an integral part in the management of invasive penile tumors with intraoperative assessment often aiding decision-making during dissection. In this study, we evaluate the diagnostic value of intraoperative frozen section (FS) and analyze clinicopathologic factors that affect its accuracy. MATERIAL AND METHODS We, retrospectively, reviewed 84 patients with squamous cell carcinoma of the penis who underwent inguinal lymph node dissection at our institution. Intraoperative FS from the superficial inguinal nodes was available in 65 patients and compared with correspondent permanent sections (pathologic node staging [pN]). Sensitivity and specificity were calculated and factors associated with a false negative event were analyzed using logistic regression. RESULTS The total positive node rate was 60% (39/65). Of 39 pN+ cases, 10 (25.6%) had false-negative FS, whereas the remaining 29 were concordant intraoperatively. Sensitivity and specificity were 0.74 and 1, respectively. On univariable analysis, higher body mass index was associated with a false negative event although there was no association with age, receipt of neoadjuvant therapy, or clinical node stage. CONCLUSION Intraoperative FS is highly specific and moderately sensitive for the detection of positive superficial inguinal lymph nodes in penile cancer. Its use can help guide intraoperative surgical planning while limiting its reliance for patients with higher body mass index.
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Affiliation(s)
- Juan Chipollini
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL.
| | - Dominic H Tang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Neil Manimala
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Scott M Gilbert
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Julio M Pow-Sang
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Wade J Sexton
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Michael A Poch
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
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12
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Leone A, Diorio GJ, Pettaway C, Master V, Spiess PE. Contemporary management of patients with penile cancer and lymph node metastasis. Nat Rev Urol 2017; 14:335-347. [PMID: 28401957 DOI: 10.1038/nrurol.2017.47] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Penile cancer is a rare disease that causes considerable physical and psychological patient morbidity, especially at advanced stages. Patients with low-stage nodal metastasis can achieve durable survival with surgery alone, but those with extensive locoregional metastasis have overall low survival. Contemporary management strategies for lymph node involvement in penile cancer aim to minimize the morbidity associated with traditional radical inguinal lymphadenectomy through appropriate risk stratification while optimizing oncological outcomes. Modified (or superficial) inguinal lymph node dissection and dynamic sentinel lymph node biopsy are diagnostic modalities that have been recommended in patients with high-risk primary penile tumours and nonpalpable inguinal lymph nodes. In addition, advances in minimally invasive and robot-assisted lymphadenectomy techniques are being investigated in patients with penile cancer and might further decrease lymphadenectomy-related adverse effects. The management of patients with advanced disease has evolved to include multimodal treatment with systemic chemotherapy before surgical intervention and can include adjuvant chemotherapy after pelvic lymphadenectomy. The role of radiotherapy in the neoadjuvant or adjuvant setting remains largely unclear, owing to a lack of high-level evidence of possible benefits. New targeted therapies have shown efficacy in squamous cell carcinomas of other sites and might also prove effective in patients with penile cancer.
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Affiliation(s)
- Andrew Leone
- H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida 33602, USA
| | - Gregory J Diorio
- H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida 33602, USA
| | - Curtis Pettaway
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit Number: 1373, Houston, Texas 77030, USA
| | - Viraj Master
- Emory University School of Medicine, 1365 Clifton Road NE, Building B, Room 1485, Atlanta, Georgia 30030, USA
| | - Philippe E Spiess
- H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida 33602, USA
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13
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Spiess PE, Dhillon J, Baumgarten AS, Johnstone PA, Giuliano AR. Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies. CA Cancer J Clin 2016; 66:481-495. [PMID: 27314890 DOI: 10.3322/caac.21354] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Answer questions and earn CME/CNE Squamous cell carcinoma (SCC) of the penis is a rare malignancy in the United States, with a significantly higher incidence-up to 20 to 30 times greater-in areas of Africa and South America. This can be explained in part by the significantly greater prevalence of sexually transmitted diseases among high-risk males often having unprotected sex with multiple sexual partners. Human papillomavirus (HPV) has been implicated as the infectious pathway by which several these penile neoplasms originate from precursor lesions. In this regard, a fundamental understanding of HPV in penile carcinogenesis can have meaningful implications in understanding 1) the diagnosis of HPV-related precursor penile lesions, 2) targeting HPV-specific molecular pathways, and 3) cancer prevention. Using vaccination programs not only may improve patient outcomes but also may minimize the need for highly aggressive and often debilitating surgical resection. CA Cancer J Clin 2016;66:481-495. © 2016 American Cancer Society.
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Affiliation(s)
- Philippe E Spiess
- Associate Member, Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Jasreman Dhillon
- Assistant Member, Department of Anatomical Pathology, Moffitt Cancer Center, Tampa, FL
| | - Adam S Baumgarten
- Urology Resident Physician, Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
| | - Peter A Johnstone
- Senior Member, Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL
| | - Anna R Giuliano
- Senior Member, Department of Infection and Cancer, Moffitt Cancer Center, Tampa, FL
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14
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Erbersdobler A. Pathologic Evaluation and Reporting of Carcinoma of the Penis. Clin Genitourin Cancer 2016; 15:192-195. [PMID: 27594553 DOI: 10.1016/j.clgc.2016.08.003] [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: 06/27/2016] [Accepted: 08/01/2016] [Indexed: 10/21/2022]
Abstract
Carcinoma of the penis is a rare tumor in the United States and in western European countries. Clinical management has become more complex in recent years, because organ-preserving strategies are being favored. Furthermore, our understanding of the pathogenesis of this malignancy has grown considerably. As a result of these developments, the demands on the pathology reports of surgical specimens from the penis have increased. There are also some peculiarities with the current World Health Organization and TNM classification systems of penile cancer as compared with other tumor entities. This review outlines the most relevant aspects that have to be considered in the pathologic handling and typing of penile carcinoma.
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15
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da Cunha IW, Souza MJL, da Costa WH, Amâncio AM, Fonseca FP, Zequi SDC, Lopes A, Guimarães GC, Soares F. Epithelial-mesenchymal transition (EMT) phenotype at invasion front of squamous cell carcinoma of the penis influences oncological outcomes. Urol Oncol 2016; 34:433.e19-26. [PMID: 27381894 DOI: 10.1016/j.urolonc.2016.05.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Revised: 04/29/2016] [Accepted: 05/12/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Our aims were to evaluate epithelial-mesenchymal transition (EMT) as a useful prognostic marker in penile carcinoma (PC), and establish an objective criterion to define EMT in PC specimens. MATERIALS AND METHODS A total of 149 consecutive cases surgically treated for PC were retrospectively selected. E-cadherin (E-CAD) and vimentin immunohistochemical expressions were evaluated. A combined analysis was performed using both markers to determine EMT status. To establish a normal control to E-CAD expression, we included 14 cases from circumcisions from patients without any neoplastic disease and 77 cases of tumor-free margins. The analyses of tumor samples were evaluated in 2 different areas of the tumor. The first one was in the tumor core. The second analyses were performed on the deepest infiltrative edge of the tumor, nominated invasion front. Cases were classified into EMT absent group, partial EMT group and complete EMT group. Overall survival (OS) and cancer-specific survival (CSS) were analyzed. Kaplan-Meier curves and the log-rank test were used. Cox proportional hazards model was used to determine which variables influenced survival. RESULTS Tumor specimens presented a significant loss of expression of E-CAD when compared with normal epithelium. Vimentin expression in more than 10% of tumor cells was observed in 50 cases. EMT status was associated with histologic grade, pattern of invasion, lymph node metastasis, and perineural and vascular invasion. Further, 10-year OS and CSS rates in patients with presence and absence of complete EMT status were 38.0% and 55.6%; and 48.0% and 91.9%, respectively. EMT status significantly affected CSS and OS rates even after patients were grouped based on lymph node involvement status. The presence of complete EMT status was associated with both CSS and OS rates. Patients in the complete EMT group had a higher risk of death from cancer (hazard ratio = 7.6, P<0.001) and overall death (hazard ratio = 3.0, P<0.001). CONCLUSION Our study represents an evidence of the prognostic effect of EMT in PC. We encourage the study of EMT markers in other centers to validate our findings and confirm its importance in such tumors.
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Affiliation(s)
| | | | | | - Alice M Amâncio
- Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | | | | | - Ademar Lopes
- Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil
| | | | - Fernando Soares
- Urology Division, A.C. Camargo Cancer Center, Sao Paulo, Brazil
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Zhai LL, Wu Y, Cai CY, Tang ZG. Upregulated matrix metalloproteinase-2 and downregulated tissue factor pathway inhibitor-2 are risk factors for lymph node metastasis and perineural invasion in pancreatic carcinoma. Onco Targets Ther 2015; 8:2827-34. [PMID: 26504399 PMCID: PMC4603725 DOI: 10.2147/ott.s90599] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Dysregulated expression of matrix metalloproteinase (MMP)-2 and tissue factor pathway inhibitor (TFPI)-2 is closely associated with tumorigenesis and tumor progression. The aim of this work was to determine the predictive values of MMP-2 and TFPI-2 in identifying lymph node metastasis (LNM) and perineural invasion (PNI) in pancreatic carcinoma. METHODS Formalin-fixed and paraffin-embedded tissue samples containing pancreatic carcinoma tissues and their corresponding para-carcinoma tissues were obtained from 122 patients with pancreatic carcinoma. The expression levels of MMP-2 and TFPI-2 were evaluated by immunohistochemistry. The roles of MMP-2 and TFPI-2 in predicting LNM and PNI in pancreatic carcinoma were analyzed. RESULTS The level of MMP-2 expression was markedly increased in pancreatic carcinoma tissues (76.9%) compared with para-carcinoma tissues (29.2%; P<0.05). In contrast, there was obviously decreased TFPI-2 expression level in pancreatic carcinoma tissues (29.2%) compared with para-carcinoma tissues (77.7%; P<0.001). Additionally, MMP-2 expression was significantly positively correlated with LNM (r=0.468, P<0.01) and PNI (r=0.637, P<0.01). In contrast, TFPI-2 expression was strongly negatively correlated with LNM (r=-0.396, P<0.001) and PNI (r=-0.460, P<0.001). Logistic regression analysis showed that high MMP-2 expression and low TFPI-2 expression acted as independent predictors for LNM and PNI in pancreatic carcinoma. CONCLUSION Taken together, our findings suggest that upregulated MMP-2 and downregulated TFPI-2 serve as useful predictors for a high risk of LNM and PNI. Obtaining information on the expression of MMP-2 and TFPI-2 before surgery may predict the occurrence of LNM and PNI, thereby permitting reasonable and effective surgical treatment for patients with pancreatic carcinoma.
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Affiliation(s)
- Lu-Lu Zhai
- Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China
| | - Yang Wu
- Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China
| | - Chong-Yang Cai
- Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China
| | - Zhi-Gang Tang
- Department of General Surgery, Affiliated Provincial Hospital, Anhui Medical University, Hefei, People's Republic of China ; Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, People's Republic of China
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Flatley B, Quaye C, Johnson E, Freeman A, Muneer A, Minhas S, Paterson JC, Musa F, Malone P, Cramer R. Distribution analysis of the putative cancer marker S100A4 across invasive squamous cell carcinoma penile tissue. EUPA OPEN PROTEOMICS 2015. [DOI: 10.1016/j.euprot.2015.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Arya M, Thrasivoulou C, Henrique R, Millar M, Hamblin R, Davda R, Aare K, Masters JR, Thomson C, Muneer A, Patel HRH, Ahmed A. Targets of Wnt/ß-catenin transcription in penile carcinoma. PLoS One 2015; 10:e0124395. [PMID: 25901368 PMCID: PMC4406530 DOI: 10.1371/journal.pone.0124395] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2014] [Accepted: 03/13/2015] [Indexed: 12/21/2022] Open
Abstract
Penile squamous cell carcinoma (PeCa) is a rare malignancy and little is known regarding the molecular mechanisms involved in carcinogenesis of PeCa. The Wnt signaling pathway, with the transcription activator ß-catenin as a major transducer, is a key cellular pathway during development and in disease, particularly cancer. We have used PeCa tissue arrays and multi-fluorophore labelled, quantitative, immunohistochemistry to interrogate the expression of WNT4, a Wnt ligand, and three targets of Wnt-ß-catenin transcription activation, namely, MMP7, cyclinD1 (CD1) and c-MYC in 141 penile tissue cores from 101 unique samples. The expression of all Wnt signaling proteins tested was increased by 1.6 to 3 fold in PeCa samples compared to control tissue (normal or cancer adjacent) samples (p<0.01). Expression of all proteins, except CD1, showed a significant decrease in grade II compared to grade I tumors. High magnification, deconvolved confocal images were used to measure differences in co-localization between the four proteins. Significant (p<0.04-0.0001) differences were observed for various permutations of the combinations of proteins and state of the tissue (control, tumor grades I and II). Wnt signaling may play an important role in PeCa and proteins of the Wnt signaling network could be useful targets for diagnosis and prognostic stratification of disease.
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Affiliation(s)
- Manit Arya
- Division of Surgery, University College Hospital, London, United Kingdom and The Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Christopher Thrasivoulou
- Research Department of Cell and Developmental Biology, The Centre for Cell and Molecular Dynamics, Rockefeller Building, University College London, London, United Kingdom
| | - Rui Henrique
- Department of Pathology, Portuguese Oncology Institute and Department of Pathology and Molecular Immunology, Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal
| | - Michael Millar
- Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Ruth Hamblin
- Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Reena Davda
- Prostate Cancer Research Centre, Division of Surgery, University College London, London, United Kingdom
| | - Kristina Aare
- Prostate Cancer Research Centre, Division of Surgery, University College London, London, United Kingdom
| | - John R. Masters
- Prostate Cancer Research Centre, Division of Surgery, University College London, London, United Kingdom
| | - Calum Thomson
- Dundee Imaging Facility, College of Life Sciences, University of Dundee, Dundee, United Kingdom
| | - Asif Muneer
- Department of Urology, University College Hospital, London, United Kingdom
| | - Hitendra R. H. Patel
- Division of Surgery, Oncology, Urology and Women's Health, University Hospital of Northern Norway, Tromso, Norway
| | - Aamir Ahmed
- Prostate Cancer Research Centre, Division of Surgery, University College London, London, United Kingdom
- * E-mail:
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Kuasne H, Cólus IMDS, Busso AF, Hernandez-Vargas H, Barros-Filho MC, Marchi FA, Scapulatempo-Neto C, Faria EF, Lopes A, Guimarães GC, Herceg Z, Rogatto SR. Genome-wide methylation and transcriptome analysis in penile carcinoma: uncovering new molecular markers. Clin Epigenetics 2015; 7:46. [PMID: 25908946 PMCID: PMC4407795 DOI: 10.1186/s13148-015-0082-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 04/06/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Despite penile carcinoma (PeCa) being a relatively rare neoplasm, it remains an important public health issue for poor and developing countries. Contrary to most tumors, limited data are available for markers that are capable of assisting in diagnosis, prognosis, and treatment of PeCa. We aimed to identify molecular markers for PeCa by evaluating their epigenomic and transcriptome profiles and comparing them with surrounding non-malignant tissue (SNT) and normal glans (NG). RESULTS Genome-wide methylation analysis revealed 171 hypermethylated probes in PeCa. Transcriptome profiling presented 2,883 underexpressed and 1,378 overexpressed genes. Integrative analysis revealed a panel of 54 genes with an inverse correlation between methylation and gene expression levels. Distinct methylome and transcriptome patterns were found for human papillomavirus (HPV)-positive (38.6%) and negative tumors. Interestingly, grade 3 tumors showed a distinct methylation profile when compared to grade 1. In addition, univariate analysis revealed that low BDNF methylation was associated with lymph node metastasis and shorter disease-free survival. CpG hypermethylation and gene underexpression were confirmed for a panel of genes, including TWIST1, RSOP2, SOX3, SOX17, PROM1, OTX2, HOXA3, and MEIS1. CONCLUSIONS A unique methylome signature was found for PeCa compared to SNT, with aberrant DNA methylation appearing to modulate the expression of specific genes. This study describes new pathways with the potential to regulate penile carcinogenesis, including stem cell regulatory pathways and markers associated to a worse prognosis. These findings may be instrumental in the discovery and application of new genetic and epigenetic biomarkers in PeCa.
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Affiliation(s)
- Hellen Kuasne
- />CIPE - International Research Center, AC Camargo Cancer Center, Rua Taguá, 440, CEP: 01508-010, Liberdade, São Paulo, SP Brazil
- />Department of Biology, Londrina State University, Londrina, PR Brazil
| | | | - Ariane Fidelis Busso
- />CIPE - International Research Center, AC Camargo Cancer Center, Rua Taguá, 440, CEP: 01508-010, Liberdade, São Paulo, SP Brazil
| | | | - Mateus Camargo Barros-Filho
- />CIPE - International Research Center, AC Camargo Cancer Center, Rua Taguá, 440, CEP: 01508-010, Liberdade, São Paulo, SP Brazil
| | - Fabio Albuquerque Marchi
- />CIPE - International Research Center, AC Camargo Cancer Center, Rua Taguá, 440, CEP: 01508-010, Liberdade, São Paulo, SP Brazil
- />Inter-institutional Grad Program on Bioinformatics, Institute of Mathematics and Statistics, USP, São Paulo, SP Brazil
| | - Cristovam Scapulatempo-Neto
- />Department of Pathology, CPOM - Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, SP Brazil
| | | | - Ademar Lopes
- />Department of Pelvic Surgery, AC Camargo Cancer Center, São Paulo, Brazil
| | | | - Zdenko Herceg
- />Epigenetics Group, International Agency for Research on Cancer (IARC), Lyon, France
| | - Silvia Regina Rogatto
- />CIPE - International Research Center, AC Camargo Cancer Center, Rua Taguá, 440, CEP: 01508-010, Liberdade, São Paulo, SP Brazil
- />Department of Urology, Faculty of Medicine, UNESP, Botucatu, SP Brazil
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Masferrer E, Ferrándiz-Pulido C, Masferrer-Niubò M, Rodríguez-Rodríguez A, Gil I, Pont A, Servitje O, García de Herreros A, Lloveras B, García-Patos V, Pujol RM, Toll A, Hernández-Muñoz I. Epithelial-to-Mesenchymal Transition in Penile Squamous Cell Carcinoma. J Urol 2015; 193:699-705. [DOI: 10.1016/j.juro.2014.07.083] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Emili Masferrer
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Carla Ferrándiz-Pulido
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Magalí Masferrer-Niubò
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Alfredo Rodríguez-Rodríguez
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Inmaculada Gil
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Antoni Pont
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Octavi Servitje
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Antonio García de Herreros
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Belen Lloveras
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Vicenç García-Patos
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Ramon M. Pujol
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Agustí Toll
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
| | - Inmaculada Hernández-Muñoz
- Department of Dermatology, Facultat de Medicina, Universitat de Barcelona, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Pompeu Fabra (EM), Barcelona, Spain
- Department of Pathology (BL), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology (RMP, AT), Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
- Department of Dermatology, Hospital Universitari Vall d’Hebron, Universitat Autònoma de Barcelona (CF-P, VG-P), Barcelona, Spain
- Department of Urology, Hospital del Mar, Parc de Salut Mar, Institut Hospital del Mar d'Investigacions Mèdiques (AR-R), Barcelona, Spain
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Agarwal G, Gupta S, Spiess PE. Novel targeted therapies for the treatment of penile cancer. Expert Opin Drug Discov 2014; 9:959-68. [DOI: 10.1517/17460441.2014.925875] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Protzel C, Spiess PE. Molecular research in penile cancer-lessons learned from the past and bright horizons of the future? Int J Mol Sci 2013; 14:19494-505. [PMID: 24077122 PMCID: PMC3821569 DOI: 10.3390/ijms141019494] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 09/11/2013] [Accepted: 09/12/2013] [Indexed: 02/06/2023] Open
Abstract
Penile cancer is a rare tumor. There is a limited understanding of the biological mediators of prognostic and therapeutic importance in penile cancer. However, there exists some fundamental understanding of the major pathways involved in the development of penile pre-neoplastic lesions and neoplasms. The aim of the present review is to highlight our current state of molecular knowledge in penile cancer to foster the necessary tools for researchers to pave major advancements in our current treatment paradigms and cancer specific outcomes.
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Affiliation(s)
- Chris Protzel
- Department of Urology, University of Rostock, Rostock 18055, Germany; E-Mail:
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-813-745-2484; Fax: +1-813-745-8494
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Lopes A. Prognostic factors and biomarkers of penile carcinoma. ACTA ACUST UNITED AC 2013; 2:925-36. [PMID: 23495866 DOI: 10.1517/17530059.2.8.925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Penile squamous cell carcinoma (SCC) is a rare malignancy with highest incidence in underdeveloped and developing countries. Oncogenic human papilloma virus (HPV) DNA, mainly types 16 and 18, are found in ∼ 100% of patients with uterine cervix carcinoma. The incidence of this virus in SCC and its variations range from 30.5 to 80%. Despite controversies, contrary to the cervical carcinoma, in the carcinogenesis and disease progression of SCC, HPV-dependent and HPV-independent tumors need to be considered. Lymphadenectomies continue to be the gold standard treatment of lymph node metastases. Undesirable accuracy on staging system methods and high rates of lymphadenectomy complications are the principal objections to these surgical procedures; therefore, the main issue in patients with SCC is to know who should or should not undergo lymphadenectomy. The search for primary tumor anatomopathological and biomarker risk factors for lymph node metastases, such as has occurred in other tumors, may be an important tool to select lymphadenectomies candidates better. Histological subtypes, tumor grade, growth pattern, tumor thickness, lymphatic embolization by neoplasic cells and depth of infiltration have been reported as important prognostic factors for lymph node metastases. In our series, lymphatic vascular permeation, palpable lymph node after primary tumor control (cN stage), pattern of invasion, p53 and PCNA immunoreactivity are independent lymph node metastases risk factors in the multivariate model. It is strongly recommended that patients be concentrated in specialized centers or cancer hospitals and multi-centric prospective studies carried out on tumor markers in this rare disease, in order to stage better lymph node disease and avoid unnecessary surgeries with high morbidity rates.
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Affiliation(s)
- Ademar Lopes
- Chief Hospital AC Camargo, Pelvic Surgery Department, Fundação Antonio Prudente, São Paulo, Brasil +55 11 3661 72 74 ; or +55 11 3887 86 49 ; +55 11 3661 72 74 ;
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Sonpavde G, Pagliaro LC, Buonerba C, Dorff TB, Lee RJ, Di Lorenzo G. Penile cancer: current therapy and future directions. Ann Oncol 2013; 24:1179-89. [PMID: 23293117 DOI: 10.1093/annonc/mds635] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background Penile cancer (PC) is a rare cancer in western countries, but is more common in parts of the developing world. Due to its rarity and the consequent lack of randomized trials, current therapy is based on retrospective studies and small prospective trials. Design Studies of PC therapy were searched in PubMed and abstracts at major conferences. Results PC is generally an aggressive malignancy characterized by early locoregional lymph node (LN) spread and later metastases in distant sites. Given the strong predictive value of LN involvement for overall survival, evaluating regional LNs is critical. Advanced LN involvement is increasingly being treated with multimodality therapy incorporating chemotherapy and/or radiation. A single superior cisplatin-based regimen has not been defined. Further advances may occur with a better collaboration on an international scale and comprehensive understanding of tumor biology. To this end, the preventive role of circumcision and understanding of the oncogenic roles of Human Papilloma Virus-16, and smoking may yield advances. Preliminary data suggest a role for agents targeting epidermal growth factor receptor and angiogenesis. Conclusion Advances in therapy for PC will require efficient trial designs, synergistic collaboration, incentives to industry and the efforts of patient advocacy groups and venture philanthropists.
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Affiliation(s)
- G Sonpavde
- Department of Medicine, Section of Medical Oncology, UAB Comprehensive Cancer Center, Birmingham
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Ferrándiz-Pulido C, de Torres I, García-Patos V. [Penile squamous cell carcinoma]. ACTAS DERMO-SIFILIOGRAFICAS 2012; 103:478-87. [PMID: 22261674 DOI: 10.1016/j.ad.2011.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2011] [Revised: 07/10/2011] [Accepted: 08/12/2011] [Indexed: 11/17/2022] Open
Abstract
Penile squamous cell carcinoma (SCC) is uncommon in Europe, where it accounts for approximately 0.7% of all malignant tumors in men. The main risk factors are poor hygiene, lack of circumcision, human papillomavirus (HPV) infection, and certain chronic inflammatory skin diseases. HPV infection is detected in 70% to 100% of all penile in situ SCCs and in 30% to 50% of invasive forms of the disease, mainly basaloid and warty SCCs. In situ tumors can be treated conservatively, but close monitoring is essential as they become invasive in between 1% and 30% of cases. The treatment of choice for penile SCC is surgery. Inguinal lymph node irradiation is no longer recommended as a prophylactic measure, and it appears that selective lymph node biopsy might be useful for reducing the morbidity associated with prophylactic inguinal lymph node dissection. Survival is directly related to lymph node involvement. Improving our knowledge of underlying molecular changes and their associated genotypes will open up new therapeutic pathways.
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Affiliation(s)
- C Ferrándiz-Pulido
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, España.
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D2-40 immunoreactivity in penile squamous cell carcinoma: a marker of aggressiveness. Hum Pathol 2011; 42:1596-602. [DOI: 10.1016/j.humpath.2010.12.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 12/20/2010] [Accepted: 12/22/2010] [Indexed: 11/23/2022]
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Weiss JM, Ridnour LA, Back T, Hussain SP, He P, Maciag AE, Keefer LK, Murphy WJ, Harris CC, Wink DA, Wiltrout RH. Macrophage-dependent nitric oxide expression regulates tumor cell detachment and metastasis after IL-2/anti-CD40 immunotherapy. J Exp Med 2010; 207:2455-67. [PMID: 20921282 PMCID: PMC2964582 DOI: 10.1084/jem.20100670] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Accepted: 09/15/2010] [Indexed: 01/03/2023] Open
Abstract
Using an orthotopic model of renal cell carcinoma, we showed previously that IL-2/anti-CD40 immunotherapy resulted in synergistic anti-tumor responses, whereas IL-2 or α-CD40 alone mediated partial transient anti-tumor effects. We now show that treatment of tumor-bearing mice with IL-2/α-CD40, but not IL-2 or α-CD40, induced significant nitric oxide synthase (NOS) 2 expression in tumor-associated macrophages. In control-treated mice (low NO), NOS2 inhibition reduced tumor burden. However, during immunotherapy (high NO), NOS2 inhibition or macrophage depletion reversed the ability of IL-2/α-CD40 treatment to reduce lung metastases but had no effect on primary tumor burden. Furthermore, IL-2/α-CD40 induced the IFN-γ- and NO-dependent decrease in matrix metalloproteinase (MMP) expression and activity, concomitant with increases in tissue inhibitor of metalloproteinase (TIMP) 1 and E-cadherin expression within tumors. Finally, treatment of tumor-bearing mice with the NO donor JS-K significantly reduced metastases. These data differentiate the mechanism for primary anti-tumor effects of IL-2/α-CD40 immunotherapy, which are independent of NO, from the NO-dependent inhibition of metastases. Furthermore, reduced MMP9 activity implicates M1-polarized macrophages within the tumor microenvironment as critical components of therapeutic response. Our data demonstrate the mechanistic basis for IL-2/α-CD40-mediated control of metastases and suggest that the context-dependent application of NO donors may hold promise for prevention of metastatic disease.
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MESH Headings
- Animals
- Antibodies, Monoclonal/immunology
- Antibodies, Monoclonal/pharmacology
- Antineoplastic Agents/pharmacology
- CD40 Antigens/antagonists & inhibitors
- CD40 Antigens/immunology
- CD40 Antigens/metabolism
- Cadherins/immunology
- Cadherins/metabolism
- Carcinoma, Renal Cell/enzymology
- Carcinoma, Renal Cell/immunology
- Carcinoma, Renal Cell/pathology
- Carcinoma, Renal Cell/therapy
- Enzyme Activation/drug effects
- Enzyme Activation/immunology
- Gene Expression Regulation, Enzymologic
- Gene Expression Regulation, Neoplastic
- Immunotherapy
- Interferon-gamma/biosynthesis
- Interferon-gamma/immunology
- Interleukin-2/pharmacology
- Macrophages/enzymology
- Macrophages/immunology
- Matrix Metalloproteinase 9/biosynthesis
- Matrix Metalloproteinase 9/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Knockout
- Neoplasm Metastasis
- Nitric Oxide Donors/pharmacology
- Nitric Oxide Synthase Type II/biosynthesis
- Nitric Oxide Synthase Type II/immunology
- Tissue Inhibitor of Metalloproteinase-1/biosynthesis
- Tissue Inhibitor of Metalloproteinase-1/immunology
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Affiliation(s)
- Jonathan M Weiss
- Cancer and Inflammation Program, SAIC-Frederick, National Cancer Institute, Frederick, MD 21702, USA
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Ficarra V, Akduman B, Bouchot O, Palou J, Tobias-Machado M. Prognostic factors in penile cancer. Urology 2010; 76:S66-73. [PMID: 20691887 DOI: 10.1016/j.urology.2010.04.008] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2010] [Revised: 04/09/2010] [Accepted: 04/09/2010] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To review the published data concerning the prognostic factors in patients with penile squamous cell carcinoma (SCC). METHODS We performed an extensive literature search using the MEDLINE databases. Multiple "free text" searches were performed, searching for the following terms individually in the fields title and abstract of the records: "squamous cell carcinoma," "penile cancer" and "prognostic factors." The search included all studies published in English until November 2008. All selected reports were classified according to the level of evidence (LE). The final grade of recommendation (GR) was determined by discussion among all panel members of the International Consultation on Penile Cancer in November 2008. RESULTS The presence of metastases in the regional lymph nodes is the main factor predicting an unfavorable prognosis for patients with penile SCC (LE 3, GR B). The prognosis varies according to the number of positive lymph nodes, the presence of uni- or bilateral inguinal extension, pelvic node involvement, and the presence of lymph node capsular involvement (LE 3, GR B). The histologic subtype, pathologic extension, histologic grade, and lymphatic and/or venous embolization are the most important variables of the primary tumor predicting for inguinal lymph node involvement (LE 3, GR B). CONCLUSIONS The use of nomograms will allow for improvements in prognostic accuracy compared with the use of each single variable (LE 3, GR B). The use of molecular prognostic factors in clinical practice awaits additional confirmatory investigation (LE 3, GR B).
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Affiliation(s)
- Vincenzo Ficarra
- Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua Monoblocco Ospedaliero, Via Giustiniani 2, Padua, Italy.
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Protzel C, Richter M, Poetsch M, Kakies C, Zimmermann U, Woenckhaus C, Klebingat KJ, Hakenberg OW, Giebel J. The role of annexins I, II and IV in tumor development, progression and metastasis of human penile squamous cell carcinomas. World J Urol 2010; 29:393-8. [PMID: 20602103 DOI: 10.1007/s00345-010-0575-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 06/16/2010] [Indexed: 12/15/2022] Open
Abstract
PURPOSE The outcome of patients with penile squamous cell carcinomas (PSCC) largely depends on occurrence of metastasis. Therefore, prognostic markers indicating the risk for tumor cell spreading would be useful. Since Annexins are potential prognostic markers in a variety of tumors, we immunohistochemically examined the expression of Annexins I, II and IV (ANX AI, ANX AII and ANX AIV) in PSCC. METHODS Samples originated from 29 patients subjected to surgical resection of invasive PSCC. Immunohistochemistry was done on paraffin-embedded sections using monoclonal antibodies against ANX AI, ANX AII and ANX AIV. Expression of ANXs was compared with clinical data. RESULTS ANX AI expression was found in conventional PSCC and was absent in basaloid and sarcomatoid subtypes. High ANX AI score was significantly associated with higher T stages (P = 0.006). Strong expression in the invasion front of carcinomas was significantly associated with the occurrence of lymph node metastasis (P = 0.001). ANX AIV expression was weak in conventional PSCC, while it was strong in basaloid and sarcomatoid subtypes. Strong expression of Annnexin IV in the invasion front also showed a significant association with metastasis (P = 0.019). CONCLUSION Expression of ANXs was different in histologic subtypes of penile carcinomas. Strong expression of ANX AI and ANX AIV in the invasion front seems to indicate a higher risk of lymph node metastasis.
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Affiliation(s)
- C Protzel
- Department of Urology, University of Rostock, E. Heydemannstr. 6, 18055 Rostock, Germany.
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33
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Nyirády P, Riesz P. [Management of penile cancer, 2009]. Orv Hetil 2010; 151:621-6. [PMID: 20348060 DOI: 10.1556/oh.2010.28787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
UNLABELLED Penile cancer is a rare anomaly. Primary tumor and lymphnodes metastasis managements are essential. Nowadays, there is a growing wish for less invasive but curative treatment. AIMS AND METHODS Newest opportunities of the management of penile cancer are reviewed according to the recent literature by the authors. It is a serious challenge and also aims to preserve a cosmetically acceptable looking penis. Because of the morbidity of the inguinal lymphadenectomy, the possibilities of less invasive procedures are shown. RESULTS Development of surgical management and re-evaluation of previous serious guidelines made possible to introduce the organ preserving surgery. Midterm oncological results are similar either performing penectomy or organ preserving surgery. Most recent knowledge in the diagnosis and management of sentinel lymph nodes helps to decrease the morbidity of the procedure and assists in faster recovery of patients. CONCLUSION Extension of penis preserving technique makes possible to avoid amputation with safe oncological result. More accurate evaluation of inguinal lymph-node status is possible with the latest diagnostic examinations. Morbidity of removal of lymph-nodes can be significantly decreased with development of the procedure.
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Affiliation(s)
- Péter Nyirády
- Semmelweis Egyetem, Altalános Orvostudományi Kar, Urológiai Klinika, Uroonkológiai Centrum, Budapest, Ulloi út 78/B 1082.
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34
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Arrabal-Polo M, Arias-Santiago S, Jiménez-Pacheco A, Zuluaga-Gómez A. Carcinoma escamocelular condilomatoso asociado al virus del papiloma humano multimetastásico. Actas Urol Esp 2010. [DOI: 10.1016/j.acuro.2009.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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35
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Uro-Onkologie – Update 2009. Urologe A 2009; 48:1056-8. [DOI: 10.1007/s00120-009-2083-4] [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]
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36
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Abstract
This article provides comprehensive review of benign diseases and neoplastic conditions of the penis. It describes and provides representative images of clinical, key pathologic features and ancillary techniques to aid in differential diagnoses. It examines these diseases from the epidemiologic standpoint, looks at environmental and genetic factors, and outlines the new histologic entities for penile neoplasms with distinct outcomes and clinical behavior that have been proposed in recent years.
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Affiliation(s)
- Matthew J Wasco
- Department of Pathology, University of Michigan, 1500 East Medical Center Drive, 2G332 UH, Ann Arbor, MI 48109, USA
| | - Rajal B Shah
- Department of Pathology, University of Michigan, 1500 East Medical Center Drive, 2G332 UH, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan, 1500 East Medical Center Drive, 2G332 UH, Ann Arbor, MI 48109, USA.
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Iborra F, Neuzillet Y, Méjean A, Lebret T. [Metastases from squamous cell carcinoma of the penis]. Prog Urol 2008; 18 Suppl 7:S392-5. [PMID: 19070821 DOI: 10.1016/s1166-7087(08)74572-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Penile cancer is a rare carcinoma and visceral metastases are uncommon. Metastasis diagnosis is carried out with TDM and MRI but markers can sometimes be helpful (ie SSCAg). There is no referent chemotherapy, a trial has been started (CAVER).
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Affiliation(s)
- F Iborra
- CHU de Montpellier, Hôpital Lapeyronie, Service d'urologie, France.
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38
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Naumann CM, Alkatout I, Al-Najar A, Korda JB, Hegele A, Bolenz C, Ziegler H, Klöppel G, Juenemann KP, van der Horst C. Lymph-node metastases in intermediate-risk squamous cell carcinoma of the penis. BJU Int 2008; 102:1102-6. [DOI: 10.1111/j.1464-410x.2008.07744.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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39
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Penile cancer: epidemiology, pathogenesis and prevention. World J Urol 2008; 27:141-50. [DOI: 10.1007/s00345-008-0302-z] [Citation(s) in RCA: 237] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2008] [Accepted: 06/09/2008] [Indexed: 11/25/2022] Open
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40
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41
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Muneer A, Kayes O, Ahmed HU, Arya M, Minhas S. Molecular prognostic factors in penile cancer. World J Urol 2008; 27:161-7. [PMID: 18548255 DOI: 10.1007/s00345-008-0275-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Accepted: 04/29/2008] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVES Penile cancer is a rare tumour in developed countries but more common in South America and East Africa. Although pathological prognostic factors have been established, there is great interest in evaluating molecular markers which correlate with prognosis and outcome. METHODS We have reviewed the current status of our understanding of the molecular biology of penile cancer in order to identify established and potential prognostic factors in penile cancer. We have conducted an extensive literature search to review the current understanding of the role of prognostic markers in penile cancer. RESULTS Although several markers have been evaluated, currently the clinical application of these markers is limited. HPV positive tumours show a variable prognostic outcome. P53 status may correlate with survival in T1 disease but further studies are required to establish the link to lymph node spread. CONCLUSIONS Pathological variables are well-established but further work is required to investigate the role of molecular markers. The development of molecular prognostic markers is important for the surveillance of patients and prediction of lymph node involvement as well as a prognostic marker for survival.
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Affiliation(s)
- Asif Muneer
- Department of Urology, University College London Hospital, 235 Euston Road, London, UK.
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42
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Mottet N, Avances C, Bastide C, Culine S, Iborra F, Lesourd A, Michel F, Rigaud J. [Penile tumors]. Prog Urol 2008; 17:1049-62. [PMID: 18153987 DOI: 10.1016/s1166-7087(07)74780-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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43
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Down-regulation of the metastasis suppressor protein KAI1/CD82 correlates with occurrence of metastasis, prognosis and presence of HPV DNA in human penile squamous cell carcinoma. Virchows Arch 2008; 452:369-75. [PMID: 18305955 DOI: 10.1007/s00428-008-0590-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2007] [Revised: 01/13/2008] [Accepted: 01/23/2008] [Indexed: 12/22/2022]
Abstract
In penile squamous cell carcinoma (PSCC), the outcome largely depends on early detection and resection of inguinal lymph node metastases. We investigated the role of metastasis suppressor protein kang ai 1 (KAI1)/cluster of differentiation 82 (CD82), which is known to be of prognostic significance for a wide variety of cancers. Moreover, we analysed the tumours for human papillomavirus (HPV) DNA and loss of heterozygosity at the 11p11.2 locus. Tissue samples of 30 primary PSCCs were investigated immunohistochemically using an anti-KAI1/CD82 polyclonal antibody. The expression was assessed according to the degree of KAI1/CD82-positive tumour cells as positive, decreased or negative. The presence of HPV6/11, HPV16 and HPV18 DNA was analysed by polymerase chain reaction. All patients with decreased or negative expression of KAI1/CD82 in primary lesions had lymph node metastases (p = 0.0002). Patients with positive KAI1/CD82 expression showed a significant better prognosis for survival compared to the other groups (p = 0.0042). Presence of HPV DNA was associated with decreased or negative KAI1/CD82 expression. Lacking or decreased expression of metastasis suppressor gene KAI1/CD82 appears to be a prognostic parameter for the occurrence of lymph node metastases in PSCC. Our study suggests an association of decreased KAI1/CD82 expression with tumour progression, development of metastases and disease-specific death.
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Riesz P, Nyirády P, Szucs M, Szendrôi A, Majoros A, Bánfi G, Kiss A, Lotz G, Törzsök P, Kelemen Z, Romics I. [Experiences in treatment and follow up of 50 patients with penile cancer]. Orv Hetil 2007; 148:1751-6. [PMID: 17827084 DOI: 10.1556/oh.2007.28120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Malignant tumour of the penis is a rare disease. Although most of the cases are squamous cell carcinoma histologically, operation is managed by the urologist because of its location. AIM AND METHOD Experience with the treatment and attendance of penile cancer is presented by the author. Results were both retrospectively and prospectively worked up. RESULTS Between June 1996 and June 2006 there was operation performed in 50 patients. Mean age of men was 63.1 (31-83) years. Ninety-four percent of tumours were squamous cell carcinoma, 2 (4%) verrucosus carcinoma, in one case malignant melanoma. Pathological T stadium was T1 in 23 cases (46%), T2 in 19 (38%) patients, in 6 (12%) cases T3 and in 1 (2%) T4. Differentiation was grade 1 in 12 (24%), grade 2 in 27 (54%) and grade 3 in 10 (20%) cases. One side inguinal lymph node metastases were found in 11 (22%) and both side in 8 (16%) patients. In anamnesis 4 (8%) patients underwent circumcision because of phimosis, and 25 (50%) patients had had phimosis by identification of cancer. Seventeen patients (34%) were given chemotherapy after surgical treatment. Mean survival time of all patients was 31,4 (2-114) months. CONCLUSION Phimosis plays an important role in development of penile cancer, that's surgical treatment does not prevent the higher chance of incidence rate. The disease behaves aggressively, spreading through lymphatic vessels, where in advanced stadium, or in low differentiation cases it is already demonstrable by diagnosis. In the choice of therapy, stadium-oriented principle should be predominant. With early operation, long-term survival can be achieved.
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Affiliation(s)
- Péter Riesz
- Semmelweis Egyetem, Altalános Orvostudományi Kar, Urológiai Klinika, Budapest.
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Abstract
Penile cancer is a rare malignancy affecting more than 400 men per year in the UK. Studies on the aetiopathogenesis of this cancer have focused on its association with the human papilloma virus; however, there have also been several studies on the genetic and molecular changes that occur. Human papilloma virus has shown differential levels of prevalence in association with different types of penile cancer. The virus seems to act as a trigger for this disease via its oncogenes. We review this process, and assess the independent genetic events that occur in penile cancer. Knowledge of this cancer is progressing slowly and could be furthered by multicentre cooperation and the formation of national tumour banks, which will aid the development of novel therapeutic agents to reduce the morbidity and mortality of penile cancer.
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Affiliation(s)
- Oliver Kayes
- Institute of Urology, Division of Surgical and Interventional Sciences, University College London, London, UK
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46
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Zhu Y, Zhou XY, Yao XD, Dai B, Ye DW. The prognostic significance of p53, Ki-67, epithelial cadherin and matrix metalloproteinase-9 in penile squamous cell carcinoma treated with surgery. BJU Int 2007; 100:204-8. [PMID: 17433031 DOI: 10.1111/j.1464-410x.2007.06908.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the prognostic significance of p53, Ki-67, epithelial cadherin (E-cadherin) and matrix metalloproteinase-9 in primary penile cancer, as the presence of lymph node metastasis and long-term survival are hard to define in penile squamous cell carcinoma. PATIENTS AND METHODS Paraffin-embedded primary tumour samples were obtained from 73 Chinese patients who had penile amputation and regional lymphadenectomy. The expression of molecular markers was determined by immunohistochemistry. Logistic regression was used to identify factors associated with lymph node metastasis, and a Cox proportional-hazards model was used to measure cancer-specific survival (CSS). RESULTS Thirty (41%) patients presented with nodal disease and the 3-year CSS rate for all patients was 72%. Lymph node metastasis was significantly correlated with tumour stage, histological grade, lymphatic and vascular embolization, and the expression of p53, Ki-67 and E-cadherin. By multivariate analysis, tumour embolization and the expression of p53 were independent predictors of metastasis. Survival analysis showed that the expression of p53 was an independent prognostic factor for CSS. In stage T1 tumours, high expression of p53 was significantly associated with metastasis and poor survival. CONCLUSION Lymphatic and vascular embolization, and p53 immunoreactivity, are helpful in establishing the probability of lymph node metastasis. The expression of p53 is an independent predictor of CSS in Chinese patients with penile cancer. In stage T1 tumours, p53 staining is an important variable determining the prognosis and treatment outcome.
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Affiliation(s)
- Yao Zhu
- Department of Urology, Fudan University Cancer Hospital, No. 270 Dong'An Road, Shanghai 200032, P.R. China
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47
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Novara G, Galfano A, De Marco V, Artibani W, Ficarra V. Prognostic factors in squamous cell carcinoma of the penis. ACTA ACUST UNITED AC 2007; 4:140-6. [PMID: 17347658 DOI: 10.1038/ncpuro0751] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Accepted: 12/21/2006] [Indexed: 11/09/2022]
Abstract
Squamous cell carcinoma (SCC) of the penis is an uncommon disease in the US and Europe. Without treatment, patients with penile SCC usually die within 2 years after diagnosis of the primary lesion, because of uncontrollable locoregional disease or from distant metastases. The spread of the tumor to the locoregional lymph nodes (lymph-node positivity) is the most relevant prognostic factor. With the available treatments, 5-year cancer-specific survival probabilities are between 75% and 93% for those patients with clinically node-negative disease, and progressively lower for those with increasingly extensive node-positive disease. Similarly, patients with pathologically proven negative nodes have 5-year cancer-specific survival probabilities ranging from 85% to 100%. While patients with a single positive superficial lymph node on pathology have very good cancer-related outcomes, patients with multiple involved lymph nodes have significantly less favorable outcomes. This article focuses on the most important issues that surround the prognosis of squamous cell carcinoma of the penis, with special attention to the prognostic nomograms for penile cancer patients published in 2006.
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Affiliation(s)
- Giacomo Novara
- Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Monoblocco Ospedaliero, Via Giustiniani 2, 35128 Padua, Italy
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Affiliation(s)
- Arthur L. Burnett
- Department of Urology, Johns Hopkins University, School of Medicine, Baltimore, Maryland
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