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Rose KM, Pham R, Zacharias NM, Ionescu F, Paravathaneni M, Marchetti KA, Sanchez D, Mustasam A, Sandstrom R, Vikram R, Dhillon J, Rao P, Schneider A, Pagliaro L, Alifrangis C, Albersen M, Roussel E, Master VA, Nazha B, Hernandez C, Moses KA, Protzel C, Montgomery J, Angel M, Tobias-Machado M, Spiess PE, Pettaway CA, Chahoud J. Neoadjuvant platinum-based chemotherapy and lymphadenectomy for penile cancer: an international, multi-institutional, real-world study. J Natl Cancer Inst 2024; 116:966-973. [PMID: 38366627 DOI: 10.1093/jnci/djae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/08/2023] [Accepted: 01/10/2024] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION This study investigated the efficacy and safety of neoadjuvant chemotherapy for locally advance penile squamous cell carcinoma for which current evidence is lacking. METHODS Included patients had locally advanced penile squamous cell carcinoma with clinical lymph node metastasis treated with at least 1 dose of neoadjuvant chemotherapy prior to planned consolidative lymphadenectomy. Objective response rates were assessed using Response Evaluation Criteria in Solid Tumors v1.1. The primary and secondary outcomes were overall survival and progression-free survival, estimated by the Kaplan-Meier method. Treatment-related adverse events were graded per the Common Terminology Criteria for Adverse Events v5.0. RESULTS A total of 209 patients received neoadjuvant chemotherapy for locally advanced and clinically node-positive penile squamous cell carcinoma. The study population consisted of 7% of patients with stage II disease, 48% with stage III, and 45% with stage IV. Grade 2 treatment-related adverse events occurred in 35 (17%) patients, and no treatment-related mortality was observed. Of the patients, 201 (97%) completed planned consolidative lymphadenectomy. During follow-up, 106 (52.7%) patients expired, with a median overall survival of 37.0 months (95% confidence interval [CI] = 23.8 to 50.1 months) and median progression-free survival of 26.0 months (95% CI = 11.7 to 40.2 months). Objective response rate was 57.2%, with 87 (43.2%) having partial response and 28 (13.9%) having a complete response. Patients with objective response to neoadjuvant chemotherapy had a longer median overall survival (73.0 vs 17.0 months, P < .01) compared with those who did not. The lymph node pathologic complete response rate was 24.8% in the cohort. CONCLUSION Neoadjuvant chemotherapy with lymphadenectomy for locally advanced penile squamous cell carcinoma is well tolerated and active to reduce the disease burden and improve long-term survival outcomes.
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Affiliation(s)
- Kyle M Rose
- Ochsner Medical Center, New Orleans, LA, USA
| | - Rachel Pham
- University of Texas Health Science Center Houston, Houston, TX, USA
| | - Niki M Zacharias
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | | | | | - Darren Sanchez
- University of Texas Health Science Center Houston, Houston, TX, USA
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | | | - Raghu Vikram
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | - Priya Rao
- University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | | | | | | | | | | | - Viraj A Master
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Bassel Nazha
- Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | | - Kelvin A Moses
- Vanderbilt University Medical Center, Nashville, TN, USA
| | | | | | - Martin Angel
- Instituto Alexander Fleming, Buenos Aires, Argentina
- Instituto Misionero del Cancer, Posadas, Misiones, Argentina
| | | | | | | | - Jad Chahoud
- H. Lee Moffitt Cancer Center, Tampa, FL, USA
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Zhao PP, Huang JH, Xu ZP. Auto-amputation of penis due to carcinoma: A case report and literature review. Asian J Surg 2024:S1015-9584(24)01081-9. [PMID: 38839497 DOI: 10.1016/j.asjsur.2024.05.189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Affiliation(s)
- Peng-Peng Zhao
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, 528000, China
| | - Jian-Hua Huang
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, 528000, China
| | - Zhan-Ping Xu
- Department of Urology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, 528000, China.
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3
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Vreeburg MTA, de Vries HM, van der Noort V, Horenblas S, van Rhijn BWG, Hendricksen K, Graafland N, van der Poel HG, Brouwer OR. Penile cancer care in the Netherlands: increased incidence, centralisation, and improved survival. BJU Int 2024; 133:596-603. [PMID: 38403729 DOI: 10.1111/bju.16306] [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] [Indexed: 02/27/2024]
Abstract
OBJECTIVE To evaluate penile squamous cell carcinoma (PSCC) incidence and centralisation trends in the Netherlands over the past three decades, as well as the effect of centralisation of PSCC care on survival. PATIENTS AND METHODS In the Netherlands PSCC care is largely centralised in one national centre of expertise (Netherlands Cancer Institute [NCI], Amsterdam). For this study, the Netherlands Cancer Registry, an independent nationwide cancer registry, provided per-patient data on age, clinical and pathological tumour staging, follow-up, and vital status. Patients with treatment at the NCI were identified and compared to patients who were treated at all other centres. The age-standardised incidence rate was calculated with the European Standard Population. The probability of death due to PSCC was estimated using the relative survival. Multivariable Cox regression analysis was performed to evaluate predictors of survival. RESULTS A total of 3160 patients were diagnosed with PSCC between 1990 and 2020, showing a rising incidence (P < 0.001). Annual caseload increased at the NCI (1% in 1990, 65% in 2020) and decreased at other (regional) centres (99% to 35%). Despite a relatively high percentage of patients with T2-4 (64%) and N+ (33%) at the NCI, the 5-year relative survival was higher (86%, 95% confidence interval [CI] 82-91%) compared to regional centres (76%, 95% CI 73-80%, P < 0.001). Patients with a pathological T2 tumour were treated with glans-sparing treatment more often at the reference centre than at the regional centres (16% vs 5.0%, P < 0.001). After adjusting for age, histological grading, T-stage, presence of lymph node involvement and year of diagnosis, treatment at regional centres remained a predictor for worse survival (hazard ratio 1.22, 95% CI 1.05-1.39; P = 0.006). CONCLUSION The incidence of PSCC in the Netherlands has been gradually increasing over the past three decades, with a noticeable trend towards centralisation of PSCC care and improved relative survival rate.
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Affiliation(s)
- Manon T A Vreeburg
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Hielke-Martijn de Vries
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Vincent van der Noort
- Department of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Simon Horenblas
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Bas W G van Rhijn
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Kees Hendricksen
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Niels Graafland
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Henk G van der Poel
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Oscar R Brouwer
- Department of Urology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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K AR, Arumugam S, Muninathan N, Baskar K, S D, D DR. P53 Gene as a Promising Biomarker and Potential Target for the Early Diagnosis of Reproductive Cancers. Cureus 2024; 16:e60125. [PMID: 38864057 PMCID: PMC11165294 DOI: 10.7759/cureus.60125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 05/10/2024] [Indexed: 06/13/2024] Open
Abstract
One of the crucial aspects of cancer research is diagnosis with specificity and accuracy. Early cancer detection mostly helps make appropriate decisions regarding treatment and metastasis. The well-studied transcription factor tumor suppressor protein p53 is essential for maintaining genetic integrity. p53 is a key tumor suppressor that recognizes the carcinogenic biological pathways and eradicates them by apoptosis. A wide range of carcinomas, especially gynecological such as ovarian, cervical, and endometrial cancers, frequently undergo TP53 gene mutations. This study evaluates the potential of the p53 gene as a biological marker for the diagnosis of reproductive system neoplasms. Immunohistochemistry of p53 is rapid, easy to accomplish, cost-effective, and preferred by pathologists as a surrogate for the analysis of TP53 mutation. Thus, this review lays a groundwork for future efforts to develop techniques using p53 for the early diagnosis of cancer.
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Affiliation(s)
- Aswathi R K
- Medical Biochemistry, Meenakshi Academy of Higher Education and Research, Chennai, IND
| | - Suresh Arumugam
- Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, IND
| | - Natrajan Muninathan
- Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, IND
| | - Kuppusamy Baskar
- Central Research Laboratory, Meenakshi Medical College Hospital and Research Institute, Kanchipuram, IND
| | - Deepthi S
- Research and Development, Meenakshi Academy of Higher Education and Research, Chennai, IND
| | - Dinesh Roy D
- Centre for Advanced Genetic Studies, Genetika, Thiruvananthapuram, IND
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Liu S, Shen Z, Yang H, Wang J, Wang X, Gong Y, Liu S, Lu Z, Huang T. Development and validation of HPV-associated and HPV-independent penile squamous cell carcinoma prognostic nomogram. Int Urol Nephrol 2024:10.1007/s11255-024-04043-3. [PMID: 38679654 DOI: 10.1007/s11255-024-04043-3] [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: 01/29/2024] [Accepted: 03/24/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE The aim of this study was to introduce HPV-associated and HPV-independent histologic classifications to analyze prognostic factors and develop a prognostic nomogram for patients with penile squamous cell carcinoma (PSCC). METHODS Data of 1502 PSCC patients between 2010 and 2020 were accessed from the SEER database, and the patients were randomly divided into a training set and a validation set. Independent risk factors for PSCC patients prognosis were analyzed by using univariate and multivariate COX proportional hazards regression, and was used for the construction of the nomogram, and the predictive performance of the model was evaluated by C-index, calibration curve and ROC curve. Kaplan-Meier analysis was applied to explore the impact of HPV-related factors on patient survival, while propensity score matching (PSM) and inverse probability treatment weighting (IPTW) techniques were used to balance other confounding factors like individual clinical and pathological factors, and to evaluate the differences in overall survival (OS) and cause-specific survival (CSS) between subgroups. RESULT The results indicated that histologic type, Grade classification, T/M stage, surgical methods and chemotherapy were independent risk factors affecting OS and CSS in PSCC patients. In addition, age and marital status were significantly associated with OS, while lymph node metastasis was an independent prognostic factor for CSS, the validation results of the model showed that the nomogram had a superior predictive performance compared with the American Joint Committee on Cancer staging system. In addition, subgroup analyses prior to and after IPTW and PSM adjustments showed that HPV-associated group had better OS and CSS than HPV-independent group. CONCLUSION Our study developed and validated a nomogram using a novel histologic classification and achieved satisfactory results, which can better help clinicians to predict the prognosis of penile squamous cell carcinoma patients.
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Affiliation(s)
- Song Liu
- Bengbu Medical University, No. 2600 Donghai Road, Bengbu, 233000, Anhui, China
| | - Zhou Shen
- Department of Urology Surgery, The First Affiliated Hospital of USTC, Hefei, Anhui, China
| | - Haoran Yang
- Bengbu Medical University, No. 2600 Donghai Road, Bengbu, 233000, Anhui, China
| | - Jing Wang
- Department of Urology Surgery, The First Affiliated Hospital of USTC, Hefei, Anhui, China
| | - Xing Wang
- Wannan Medical College, Wuhu, Anhui, China
| | | | - Shuhan Liu
- Department of Urology Surgery, The First Affiliated Hospital of USTC, Hefei, Anhui, China
| | - Zhipeng Lu
- Bengbu Medical University, No. 2600 Donghai Road, Bengbu, 233000, Anhui, China
| | - Tao Huang
- Bengbu Medical University, No. 2600 Donghai Road, Bengbu, 233000, Anhui, China.
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Elst L, Philips G, Vandermaesen K, Bassez A, Lodi F, Vreeburg MTA, Brouwer OR, Schepers R, Van Brussel T, Mohanty SK, Parwani AV, Spans L, Vanden Bempt I, Jacomen G, Baldewijns M, Lambrechts D, Albersen M. Single-cell Atlas of Penile Cancer Reveals TP53 Mutations as a Driver of an Aggressive Phenotype, Irrespective of Human Papillomavirus Status, and Provides Clues for Treatment Personalization. Eur Urol 2024:S0302-2838(24)02266-8. [PMID: 38670879 DOI: 10.1016/j.eururo.2024.03.038] [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: 01/12/2024] [Revised: 03/11/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND AND OBJECTIVE TP53 loss-of-function (TP53LOF) mutations might be a driver of poor prognosis and chemoresistance in both human papillomavirus (HPV)-independent (HPV-) and HPV-associated (HPV+) penile squamous cell carcinoma (PSCC). Here, we aim to describe transcriptomic differences in the PSCC microenvironment stratified by TP53LOF and HPV status. METHODS We used single-cell RNA sequencing (scRNA-seq) and T-cell receptor sequencing to obtain a comprehensive atlas of the cellular architecture of PSCC. TP53LOF and HPV status were determined by targeted next-generation sequencing and sequencing HPV-DNA reads. Six HPV+ TP53 wild type (WT), six HPV- TP53WT, and four TP53LOF PSCC samples and six controls were included. Immunohistochemistry and hematoxylin-eosin confirmed the morphological context of the observed signatures. Prognostic differences between patient groups were validated in 541 PSCC patients using Kaplan-Meier survival estimates. KEY FINDINGS AND LIMITATIONS Patients with aberrant p53 staining fare much worse than patients with either HPV- or HPV+ tumors and WT p53 expression. Using scRNA-seq, we revealed 65 cell subtypes within 83 682 cells. TP53LOF tumors exhibit a partial epithelial-to-mesenchymal transition, immune-excluded, angiogenic, and morphologically invasive environment, underlying their aggressive phenotype. HPV- TP53WT tumors show stemness and immune exhaustion. HPV+ TP53WT tumors mirror normal epithelial maturation with upregulation of antibody-drug-conjugate targets and activation of innate immunity. Inherent to the scRNA-seq analysis, low sample size is a limitation and validation of signatures in large PSCC cohorts is needed. CONCLUSIONS AND CLINICAL IMPLICATIONS This first scRNA-seq atlas offers unprecedented in-depth insights into PSCC biology underlying prognostic differences based on TP53 and HPV status. Our findings provide clues for testing novel biomarker-driven therapies in PSCC. PATIENT SUMMARY Here, we analyzed tissues of penile cancer at the level of individual cells, which helps us understand why patients who harbor a deactivating mutation in the TP53 gene do much worse than patients lacking such a mutation. Such an analysis may help us tailor future therapies based on TP53 gene mutations and human papillomavirus status of these tumors.
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Affiliation(s)
- Laura Elst
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium; Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Gino Philips
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Kaat Vandermaesen
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium; Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Ayse Bassez
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Francesca Lodi
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Manon T A Vreeburg
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Oscar R Brouwer
- Department of Urology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Rogier Schepers
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Thomas Van Brussel
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, Advanced Medical Research Institute, Bhubaneswar, India; Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Anil V Parwani
- Department of Pathology, Wexner Medical Center, Columbus, OH, USA
| | - Lien Spans
- Department of Human Genetics, University Hospitals Leuven, Leuven, Belgium
| | | | - Gerd Jacomen
- Laboratory of Pathological Anatomy, AZ Sint-Maarten, Mechelen, Belgium
| | | | - Diether Lambrechts
- Center for Cancer Biology, Laboratory of Translational Genetics, VIB-KU Leuven, Leuven, Belgium
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Belgium; Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
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Karaoğlan BB, Ürün Y. Unveiling the Role of Human Papillomavirus in Urogenital Carcinogenesis a Comprehensive Review. Viruses 2024; 16:667. [PMID: 38793549 PMCID: PMC11125962 DOI: 10.3390/v16050667] [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: 02/29/2024] [Revised: 03/27/2024] [Accepted: 04/09/2024] [Indexed: 05/26/2024] Open
Abstract
Human papillomavirus (HPV), an oncogenic DNA virus, is the most common sexually transmitted virus and significant public health concern globally. Despite the substantial prevalence of HPV infection among men, routine testing remains elusive due to the lack of approved HPV tests and the complexity of detection methods. Various studies have explored the link between HPV and genitourinary cancers, revealing different associations influenced by geographic variation, histological subtype and methodological differences. These findings underscore the importance of further research to elucidate the role of HPV in male urogenital cancers. This comprehensive review delves into the intricate relationship between HPV and male genitourinary cancers, shedding light on the virus's oncogenic mechanisms and its reported prevalence. A deeper understanding of HPV's implications for male health is essential for advancing public health initiatives and reducing the burden of urogenital cancers worldwide.
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Affiliation(s)
- Beliz Bahar Karaoğlan
- Department of Medical Oncology, Ankara University Faculty of Medicine, 06620 Ankara, Türkiye;
- Faculty of Medicine, Department of Internal Medicine, Division of Internal Medicine, Ankara University Cancer Research Institute, 06620 Ankara, Türkiye
| | - Yüksel Ürün
- Department of Medical Oncology, Ankara University Faculty of Medicine, 06620 Ankara, Türkiye;
- Faculty of Medicine, Department of Internal Medicine, Division of Internal Medicine, Ankara University Cancer Research Institute, 06620 Ankara, Türkiye
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Hrudka J, Hojný J, Prouzová Z, Kendall Bártů M, Čapka D, Zavillová N, Matěj R, Waldauf P. High tumour mutational burden is associated with strong PD-L1 expression, HPV negativity, and worse survival in penile squamous cell carcinoma: an analysis of 165 cases. Pathology 2024; 56:357-366. [PMID: 38161143 DOI: 10.1016/j.pathol.2023.10.010] [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: 07/18/2023] [Revised: 09/26/2023] [Accepted: 10/15/2023] [Indexed: 01/03/2024]
Abstract
Penile squamous cell carcinoma (pSCC) is a rare tumour with a variable prognosis. More prognostic markers linked to mutational signatures and the tumour immune microenvironment are needed. A cohort made up of 165 invasive pSCC was retrospectively analysed using formalin-fixed, paraffin-embedded tumour tissue, focusing on tumour mutational burden (TMB), programmed death ligand 1 (PD-L1) expression, microsatellite instability (MSI), the number of tumour infiltrating lymphocytes (TILs) expressing cytotoxic T-lymphocyte-associated protein 4 (CTLA4), HPV status determined by p16 immunohistochemistry, and several traditional histopathological variables. High TMB (>10 mut/Mb) was associated with high PD-L1 expression (TPS 50-100%), and HPV-negative status. High PD-L1 expression was linked to HPV negativity, a high number of intratumoural CTLA4+ cells, and brisk lymphocytic infiltrate. High TMB was a significant predictor of shorter overall survival (OS) in both univariate and multivariate analysis when using a median cut-off value of 4.3 mut/Mb, but not when using an arbitrary cut-off of 10 mut/Mb. Low CTLA4+ cell infiltration at the tumour invasion front was a marker of shorter OS and cancer-specific survival in both univariate and multivariate analysis. PD-L1 expression had no significant impact on prognosis. Only two cases were MSI high. The results support the hypothesis of two aetiological pathways in pSCC cancerogenesis: (1) SCC linked to HPV infection characterised by low TMB, less common PD-L1 expression, and a lower number of TILs; and (2) SCC linked to chronic inflammation leading to a high number of acquired mutations (high TMB), HPV negativity, increased neoantigen production (i.e., PD-L1), and high immune cell infiltration.
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Affiliation(s)
- Jan Hrudka
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Jan Hojný
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Zuzana Prouzová
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Michaela Kendall Bártů
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - David Čapka
- Department of Urology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Nicolette Zavillová
- Department of Urology, 3rd Faculty of Medicine of Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Radoslav Matěj
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic; Department of Pathology and Molecular Medicine, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesia and Intensive Care Medicine, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
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9
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Lu Y, Clifford GM, Fairley CK, Grulich AE, Garland SM, Xiao F, Wang Y, Zou H. Human papillomavirus and p16 INK4a in oropharyngeal squamous cell carcinomas: A systematic review and meta-analysis. Int J Cancer 2024; 154:830-841. [PMID: 37861207 DOI: 10.1002/ijc.34763] [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: 04/27/2023] [Revised: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023]
Abstract
We intended to update human papillomavirus (HPV) prevalence and p16INK4a positivity in oropharyngeal squamous cell carcinomars (SCC), and calculate HPV attributable fraction (AF) for oropharyngeal SCC by geographic region. We searched Medline, Embase, and the Cochrane Library to identify published studies of HPV prevalence and p16INK4a positivity alone or together in oropharyngeal SCC before December 28, 2021. Studies that reported type-specific HPV DNA prevalence using broad-spectrum PCR-based testing methods were included. We estimated pooled HPV prevalence, type-specific HPV prevalence, and p16INK4a positivity. AF of HPV was calculated by geographic region. One hundred and thirty-four studies including 12 139 cases were included in our analysis. The pooled HPV prevalence estimate for oropharyngeal SCC was 48.1% (95% confidence interval [CI] 43.2-53.0). HPV prevalence varied significantly by geographic region, and the highest HPV prevalence in oropharyngeal SCC was noted in North America (72.6%, 95% CI 63.8-80.6). Among HPV positive cases, HPV 16 was the most common type with a prevalence of 40.2% (95% CI 35.7-44.7). The pooled p16INK4a positivity in HPV positive and HPV16 positive oropharyngeal SCC cases was 87.2% (95% CI 81.6-91.2) and 91.7% (84.3-97.2). The highest AFs of HPV and HPV16 were noted in North America at 69.6% (95% CI 53.0-91.5) and 63.0% (48.0-82.7). [Correction added on 31 October 2023, after first online publication: the percentage symbol (%) was missing and has been added to 63.0% (48.0-82.7) in the Abstract and Conclusion.] A significant proportion of oropharyngeal SCC was attributable to HPV. HPV16 accounts for the majority of HPV positive oropharyngeal SCC cases. These findings highlight the importance of HPV vaccination in the prevention of a substantial proportion of oropharyngeal SCC cases.
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Affiliation(s)
- Yong Lu
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Gary M Clifford
- Early Detection, Prevention and Infections Branch, International Agency for Research on Cancer (IARC/WHO), Lyon, France
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, The Alfred, Melbourne, Australia
- Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Andrew E Grulich
- Kirby Institute, The University of New South Wales, Sydney, Australia
| | - Suzanne M Garland
- Royal Women's Hospital, University of Melbourne, Murdoch Children's Research Institute, Melbourne, Australia
| | - Fei Xiao
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Yuan Wang
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China
- School of Public Health, Southwest Medical University, Luzhou, China
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10
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Safa H, Mercinelli C, Spiess PE, Necchi A, Chahoud J. Insights into the management of penile squamous cell carcinoma: from conventional approaches to emerging novel therapies. Expert Opin Pharmacother 2024; 25:447-465. [PMID: 38549550 DOI: 10.1080/14656566.2024.2337244] [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: 01/11/2024] [Accepted: 03/27/2024] [Indexed: 04/04/2024]
Abstract
INTRODUCTION Penile squamous cell carcinoma (PSCC), a rare genitourinary cancer, is associated with poor outcomes due to limited treatment effectiveness, especially in advanced stages. AREAS COVERED While chemotherapy and/or surgery remain the standard of care, emerging therapies like immunotherapy, targeted therapy, and human papillomavirus (HPV) directed therapies show promise. Key to advancing treatment is understanding the immune microenvironment to gain insights into tumor resistance mechanisms and potential therapeutic targets. The scarcity of data on PSCC is a major obstacle in advancing research for this rare cancer. EXPERT OPINION Future research should prioritize collaborative efforts across various research centers and countries. Enhancing data sharing and pooling resources can lead to a more comprehensive understanding of PSCC, ultimately supporting the development of precision medicine strategies tailored to this specific cancer type. This collaborative approach is essential for making significant strides in PSCC treatment and care.
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Affiliation(s)
- Houssein Safa
- Department of Hematology/Oncology, Baylor College of Medicine, Houston, TX, USA
| | - Chiara Mercinelli
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Andrea Necchi
- Department of Medical Oncology, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milano, Italy
| | - Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
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11
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Pang KH, Fallara G, Hemat M, Ghosh A, Haider A, Freeman A, Hadway P, Nigam R, Rees R, Mitra A, Alifrangis C, Muneer A, Alnajjar HM. Long-term outcomes of penile squamous cell carcinoma in men age ≤50 years old compared with men >50 years old from a single tertiary referral centre: a propensity score matched analysis. Int J Impot Res 2024:10.1038/s41443-024-00842-5. [PMID: 38424353 DOI: 10.1038/s41443-024-00842-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/23/2024] [Accepted: 02/09/2024] [Indexed: 03/02/2024]
Abstract
Penile cancer (PeCa) is rare, and the oncological outcomes in younger men are unclear. We aimed to analyse and compare oncological outcomes of men age ≤50 years (y) and >50 years with PeCa. A retrospective analysis of men ≤50 y with penile squamous cell carcinoma managed at a tertiary centre was performed. A propensity score matched cohort of men >50 y was identified for comparison. Matching was according to tumour, nodal stage and the types of primary surgery. Overall survival (OS), disease-specific survival (DSS), recurrence-free survival (RFS), and metastasis-free survivals (MFS) were estimated using Kaplan-Meier plots and compared using log-rank tests. Between 2005-2020, 100 men ≤50 y (median (IQR) age, 46 y (40-49)) were identified and matched with 100 men >50 y (median (IQR) age, 65 y (59-73)). 10, 24, 32, 34 men age ≤50 y were diagnosed in 2005-2007, 2008-2012, 2013-2016 and 2017-2020 respectively. Median (IQR) follow-up was 53.5 (18-96) months. OS at 2 years: ≤50 y, 86%>50 y, 80.6%; 5 years: ≤50 y, 78.1%, >50 y, 63.1%; 10 years: ≤50 y, 72.3%, >50 y, 45.6% (p = 0.01). DSS at 2 years: ≤50 y, 87.2%>50 y, 87.8%; 5 years: ≤50 y, 80.9%>50 y, 78.2%; 10 years: ≤50 y, 78%, >50 y, 70.9% (p = 0.74). RFS was 93.1% in the ≤50 y group (vs. >50 y, 96.5%) at 2 year, and 90% (vs. >50 y, 88.5%) at 5 years, p = 0.81. Within the ≤50 y group, 2 years and 5 years MFS was 93% (vs. >50 y, 96.5%), and 89.5% (vs. >50 y, 92.7%) respectively, (p = 0.40). There were no statistical significance in DFS, RFS and MFS in men age ≤50 y and >50 y. PeCa in younger patients is fatal, public awareness and patient education are crucial for early detection and management.
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Affiliation(s)
- Karl H Pang
- Division of Urology, Department of Surgery, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong
- Division of Urology, Queen Mary Hospital, Hong Kong, HK, Hong Kong
- Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Giuseppe Fallara
- Department of Urology, European Institute of Oncology, Milan, Italy
| | - Morwarid Hemat
- Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Akash Ghosh
- Institute of Andrology, 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
- Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Urology, Royal Berkshire NHS Foundation Trust, Reading, UK
| | - Raj Nigam
- Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK
- Department of Urology, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Rowland Rees
- 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
| | - Constantine Alifrangis
- Department of Medical Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - Asif Muneer
- Institute of Andrology, 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
- NIHR Biomedical Research Centre, University College London Hospitals NHS Foundation Trust, London, UK
| | - Hussain M Alnajjar
- Institute of Andrology, University College London Hospitals NHS Foundation Trust, London, UK.
- Division of Surgery and Interventional Science, University College London, London, UK.
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12
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Ionescu F, Nguyen J, Segura CM, Paravathaneni M, Grass GD, Johnstone P, Zacharias NM, Pettaway CA, Lu X, Kim Y, Whiting J, Dhillon J, Eschrich SA, Chadha J, Gullapalli K, Roman Souza G, Miyagi H, Manley BJ, Spiess PE, Chahoud J. Multiplex Immunofluorescence Captures Progressive Immune Exhaustion with Advancing Penile Squamous Cell Cancer Stage. Cancers (Basel) 2024; 16:303. [PMID: 38275860 PMCID: PMC10814242 DOI: 10.3390/cancers16020303] [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: 12/04/2023] [Revised: 12/25/2023] [Accepted: 01/05/2024] [Indexed: 01/27/2024] Open
Abstract
Penile squamous cell carcinoma (PSCC) is a rare and deadly malignancy. Therapeutic advances have been stifled by a poor understanding of disease biology. Specifically, the immune microenvironment is an underexplored component in PSCC and the activity of immune checkpoint inhibitors observed in a subset of patients suggests immune escape may play an important role in tumorigenesis. Herein, we explored for the first time the immune microenvironment of 57 men with PSCC and how it varies with the presence of human papillomavirus (HPV) infection and across tumor stages using multiplex immunofluorescence of key immune cell markers. We observed an increase in the density of immune effector cells in node-negative tumors and a progressive rise in inhibitory immune players such as type 2 macrophages and upregulation of the PD-L1 checkpoint in men with N1 and N2-3 disease. There were no differences in immune cell densities with HPV status.
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Affiliation(s)
- Filip Ionescu
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Jonathan Nguyen
- Pathology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | | | - Mahati Paravathaneni
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - G. Daniel Grass
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Peter Johnstone
- Radiation Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Niki M. Zacharias
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Curtis A. Pettaway
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Xin Lu
- Department of Biological Sciences, University of Notre Dame, Norte Dame, IN 46556, USA;
| | - Youngchul Kim
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Junmin Whiting
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Jasreman Dhillon
- Pathology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Steven A. Eschrich
- Biostatistics and Bioinformatics Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Juskaran Chadha
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Keerthi Gullapalli
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Gabriel Roman Souza
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Hiroko Miyagi
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Brandon J. Manley
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Philippe E. Spiess
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
| | - Jad Chahoud
- Genitourinary Oncology Department, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA; (F.I.); (M.P.); (J.C.); (P.E.S.)
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13
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Guimaraes MJ, Macieira R, Azevedo F, Lisboa C. Association between HPV infection and penile cancer and penile intraepithelial neoplasia: A retrospective observational study. J Eur Acad Dermatol Venereol 2024; 38:186-190. [PMID: 37528497 DOI: 10.1111/jdv.19393] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/11/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Penile cancer is rising in most European countries. Several risk factors have been identified, namely human papillomavirus (HPV) infection. However, the exact role of HPV in penile cancer carcinogenesis is still unknown. Clarifying the contribution of HPV in penile cancer is crucial as it may improve prevention and treatment strategies. OBJECTIVE To describe the characteristics of patients with penile cancer and penile intraepithelial neoplasia (PeIN), evaluate the prevalence of HPV-DNA in tumour tissue and identify differences between patients with and without HPV-DNA. METHODS A retrospective observational study including patients with histological diagnosis of penile squamous cell carcinoma (SCC) or PeIN between 2012 and 2021 in a university hospital was carried out. HPV analysis was performed using Anyplex™ II HPV28 Detection that detects and identifies 28 HPV types. (sensitivity of 95.9%). RESULTS A total of 25 patients were included. Most of the tumours identified were invasive SCC (n = 11) and SCC in situ (PeIN 3) (n = 8). PeIN1/2 was found in the remaining six patients. HPV-DNA was tested in all tissue specimens and was detected in 18 of them. High risk HPV DNA was identified in all positive HPV samples, except one. HPV types included in the nonavalent HPV vaccine were identified in 16 of the 18 samples positive for HPV-DNA. Stratifying patients according to HPV-DNA detection, we found that patients with HPV-DNA were younger (57.5 years vs. 70 years, p = 0.047), less likely to have phimosis (5.8% vs. 42.9%, p = 0.022) and more likely to have PeIN lesions than invasive SCC (85.7% vs. 27.8%, p = 0.025). CONCLUSION This study shows a prevalence of HPV-DNA in penile SCC and premalignant lesions of 45.5% and 92.9%, respectively. Identifying HPV involvement in SCC and PeIN pathology has the potential to guide treatment and enhance follow-up strategies.
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Affiliation(s)
| | - R Macieira
- Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
| | - F Azevedo
- Department of Dermatovenereology, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - C Lisboa
- Microbiology, Department of Pathology, Faculty of Medicine, University of Porto, Porto, Portugal
- Department of Dermatovenereology, Centro Hospitalar Universitário de São João, Porto, Portugal
- CINTESIS - Centre for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
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14
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Zheng L, Zheng L, Chen S, Liu W, Qi J, Li K. Human papillomavirus prevalence and genotype distribution in Liaocheng men between 2016 and 2022. J Med Virol 2024; 96:e29360. [PMID: 38178597 DOI: 10.1002/jmv.29360] [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: 05/18/2023] [Revised: 08/28/2023] [Accepted: 12/15/2023] [Indexed: 01/06/2024]
Abstract
Human papillomavirus (HPV) infection can lead to HPV-related cancer in men, including the anus, penile, and oropharyngeal cancers and precancerous lesions. This study retrospectively investigated HPV prevalence and genotype distribution in Liaocheng men between 2016 and 2022. The total HPV positive rate was 64.87% (2388/3681, 95% confidence interval [CI]: 63.32%-66.40%), where high risk (HR)-HPV and low risk (LR)-HPV accounted for 42.49% (1564/3681, 95% CI: 40.90%-44.09%) and 69.71% (2566/3681, 95% CI: 68.20%-71.17%), respectively. The mixed HPV infection rate of two and more genotypes was 35.72%. The infection rate of HR-HPV increased with the number of positive cases annually from 2016 (16.91%) to 2022 (46.59%). The most common HR-HPV genotypes were HPV16 (11.60%), HPV52 (6.95%), and HPV59 (6.28%), whereas the least common HR-HPV was HPV26. The most common LR-HPV genotypes were HPV6 (56.99%), HPV11 (23.79%), and HPV43 (6.37%). The 9 v HPV vaccine preventable for LR-HPV and HR-HPV accounted for 80.78% and 30.40%, respectively, in this study. Most HPV-positive patients aged 1-86 were in the 30-39 age group. This study confirmed that HPV prevalence in Liaocheng men was common and diverse. HPV16, HPV52, and HPV59 are widely distributed in Liaocheng men, and the male HR-HPV infection rate remained high in this region. Regarding public health and cancer prevention, it is recommended and effective to include the HPV vaccination in the national vaccination program for men.
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Affiliation(s)
- Lili Zheng
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Liyuan Zheng
- School of Rehabilitation Sciences and Engineering, University of Health and Rehabilitation Sciences, Shandong, China
| | - Shuangfeng Chen
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Wenhui Liu
- Department of Dermatology Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Jieyu Qi
- Clinical Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
| | - Ke Li
- Central Laboratory of Liaocheng Peoples' Hospital, Liaocheng, Shandong, China
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15
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Fujimoto K, Hashimoto D, Kim SW, Lee YS, Suzuki T, Nakata M, Kumegawa S, Asamura S, Yamada G. Novel erectile analyses revealed augmentable penile Lyve-1, the lymphatic marker, expression. Reprod Med Biol 2024; 23:e12570. [PMID: 38566911 PMCID: PMC10985380 DOI: 10.1002/rmb2.12570] [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: 12/26/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The pathophysiology of penis extends to erectile dysfunction (ED) to conditions including sexually transmitted diseases (STDs) and cancer. To date, there has been little research evaluating vascular drainage from the penis. We aimed to evaluate penile blood flow in vivo and analyze its possible relationship with the lymphatic maker. Materials and Methods We established an in vivo system designed to assess the dynamic blood outflow from the corpus cavernosum (CC) by dye injection. To analyze lymphatic characteristics in the CC, the expression of Lyve-1, the key lymphatic endothelium marker, was examined by the in vitro system and lipopolysaccharide (LPS) injection to mimic the inflammatory conditions. Results A novel cavernography methods enable high-resolution morphological and functional blood drainage analysis. The expression of Lyve-1 was detected along the sinusoids. Furthermore, its prominent expression was also observed after penile LPS injection and in the erectile condition. Conclusions The current in vivo system will potentially contribute to the assessment of penile pathology from a novel viewpoint. In addition, current analyses revealed inducible Lyve-1 expression for LPS injection and the erection state, which requires further analyses on penile lymphatic system.
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Affiliation(s)
- Kota Fujimoto
- Department of Developmental Genetics, Institute of Advanced MedicineWakayama Medical UniversityWakayamaJapan
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Daiki Hashimoto
- Department of Developmental Genetics, Institute of Advanced MedicineWakayama Medical UniversityWakayamaJapan
- Department of Physiology and Regenerative Medicine, Faculty of MedicineKindai UniversityOsakaJapan
| | - Sang Woon Kim
- Department of Urology, Urological Science InstituteYonsei University College of MedicineSeoulKorea
| | - Yong Seung Lee
- Department of Urology, Urological Science InstituteYonsei University College of MedicineSeoulKorea
| | - Takuya Suzuki
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Masanori Nakata
- Department of Physiology, Faculty of MedicineWakayama Medical UniversityWakayamaJapan
| | - Shinji Kumegawa
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Shinichi Asamura
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
| | - Gen Yamada
- Department of Developmental Genetics, Institute of Advanced MedicineWakayama Medical UniversityWakayamaJapan
- Department of Plastic and Reconstructive SurgeryWakayama Medical UniversityWakayamaJapan
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16
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Zou Y, Tan X, Yuan G, Tang Y, Wang Y, Yang C, Luo S, Wu Z, Yao K. SPP1 is associated with adverse prognosis and predicts immunotherapy efficacy in penile cancer. Hum Genomics 2023; 17:116. [PMID: 38111044 PMCID: PMC10729401 DOI: 10.1186/s40246-023-00558-5] [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: 06/15/2023] [Accepted: 11/22/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The effect of SPP1 in squamous cell carcinoma of the penis (PSCC) remained unknown. We attempted to clarify the function of the SPP1 gene in PSCC. METHOD Eight paired penile cancer specimens (including penile cancer tissue, paracancerous tissue, and positive lymph node tissue) subjected to whole transcriptome sequencing were analysed to identify differentially expressed genes. We used immunohistochemistry to detect the expression of SPP1 protein and immune cell related proteins in penile cancer tissue. Then, we performed weighted gene coexpression network analysis (WGCNA) to identify the genes related to SPP1 in penile cancer tissue and positive lymph node tissue. Based on the GSE57955 dataset, the CIBERSORT and ssGSEA algorithms were carried out to investigate the immune environment of PSCC. GSVA analysis was conducted to identify the signaling pathways related to SPP1 subgroups. Enzyme-linked immunosorbent assay (ELISA) method was adopted to detect SPP1 level in the serum of 60 patients with penile cancer. RESULTS Differential analysis indicated that SPP1 was the most differentially upregulated gene in both penile cancer tissues and positive lymph node tissues. Survival analysis suggested that the prognosis of the low-SPP1 group was significantly poorer than that of the high-SPP1 group. Subsequently, immune-related bioinformatics showed that SPP1 was significantly associated with B cells, CD8 + T cells, CD4 + T cells, macrophages, helper T cells, neutrophils and dendritic cells. The immunohistochemical results showed that the high-SPP1 group was characterized by relatively high expression of CD16 and relatively low expression of CD4. GSVA analysis indicated that high-SPP1 group was significantly associated with immune-related pathways such as PD-L1 expression and the PD-1 checkpoint pathway in cancer and the TNF signaling pathway. ELISA demonstrated that the serum level of SPP1 in patients with positive lymph node metastasis of penile cancer was significantly higher than that in patients with negative lymph node metastasis of penile cancer. CONCLUSION Our study shows that the SPP1 gene might be an effective biomarker for predicting the prognosis and the efficacy of immunotherapy in PSCC patients.
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Affiliation(s)
- Yuantao Zou
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Xingliang Tan
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Gangjun Yuan
- Department of Urology Oncological Surgery, Chongqing University Cancer Hospital, Chongqing, 400030, China
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, China
| | - Yi Tang
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Yanjun Wang
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Cong Yang
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Sihao Luo
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China
| | - Zhiming Wu
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China.
| | - Kai Yao
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in Southern China, Guangzhou, 510060, China.
- Collaborative Innovation Center of Cancer Medicine, Guangzhou, 510060, China.
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Guangzhou, 510060, China.
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17
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Ortiz-Guerra RA, Jaime-Casas S, Martinez-Cannon BA, Ariza-Avila JC, González-Morales AP, Bardan-Duarte A, Remolina-Bonilla YA, Spiess PE, Bourlon MT. Overview and characterization of penile cancer content across social media platforms. Front Oncol 2023; 13:1301973. [PMID: 38169747 PMCID: PMC10758611 DOI: 10.3389/fonc.2023.1301973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/15/2023] [Indexed: 01/05/2024] Open
Abstract
Background Social media platforms (SMP) are an emerging resource that allows physicians, patients, and families to converse on cancer prevention, diagnosis, and treatment. We aimed to characterize penile cancer (PC) content shared on SMP. Methods We searched PC posts on Twitter, Facebook, and Instagram from July 1st, 2021, through June 30th, 2022. Two independent, blinded reviewers analyzed the hashtags: #PenileCancer, #PenileCancerAwareness, and #PenileNeoplasm. Descriptive statistics were used for posts characterization, Pearson´s correlation coefficient for associations, and Cohen's weighted kappa coefficient for inter-rater agreement rate. Results A total of 791 posts were analyzed, with Twitter accounting for 52%, Facebook for 12.2%, and Instagram for 35.5%, and. Most posts originated from high-income countries, such as the United Kingdom (48.8%). We found no correlation between the number of posts with PC incidence (p = 0.64) or users on SMP (p = 0.27). Most accounts were classified as "support and awareness communities" (43.6%) and "physicians and clinical researchers" (38.2%). Urology was the most common medical specialty to post (60.9%), followed by oncology (11.3%). Most posts were classified as "prevention and awareness for users" (45.1%). Global inter-reviewer agreement rate was almost perfect (k=0.95; p ≤ 0.01). On Twitter, "physicians and clinical researchers" shared more content on "treatment updates and medical papers published in medical journals," while on Facebook and Instagram, "support and awareness communities" focused on "personal and support comments." Conclusion Overall, the number of PC posts was low compared to other neoplasms across the SMP evaluated in this study. "Physicians and clinical researchers" shared more content on Twitter, while "support and awareness communities" on Facebook and Instagram. Encouraging the use of a common SMP among the medical community and general users could lead to a more effective communication between physicians, patients, and support groups, and to increased awareness of PC.
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Affiliation(s)
- Ruben Alejandro Ortiz-Guerra
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Salvador Jaime-Casas
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | | | | | | | | | - Yuly A. Remolina-Bonilla
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Philippe E. Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, United States
| | - Maria T. Bourlon
- Department of Hematology and Oncology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
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18
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Crook J. The role of radiotherapy in the management of squamous cell cancer of the penis. World J Urol 2023; 41:3913-3920. [PMID: 37994970 DOI: 10.1007/s00345-023-04683-7] [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: 08/05/2023] [Accepted: 10/08/2023] [Indexed: 11/24/2023] Open
Abstract
PURPOSE To review the evidence for radiotherapy in the management of primary penile cancer, either as brachytherapy or external beam radiation, and the role of external beam radiotherapy in node positive penile cancer. METHODS English language literature was reviewed for the past 3 decades. As penile cancer is uncommon in developed nations, high quality evidence to guide management is limited. Single institution reports often span decades during which time staging systems and treatments have evolved, reducing their relevance to current practice. Successful clinical trials require collaboration not only among disciplines but also among multiple institutions and nations. RESULTS Radiotherapy is a definitive organ-preserving option for T1-T2 penile cancers. Interstitial brachytherapy is associated with penile preservation in 85% of men at 5 years, maintained in 70% by 10 years. Results of external radiotherapy are not quite as promising but nonetheless 60% of men will have an intact penis at 5 years. Inguino-pelvic external radiotherapy has been reported to increase overall survival when delivered as adjuvant treatment for men with pN3 groin but pN0 pelvic nodes, and improve disease specific survival for those with involved pelvic nodes. InPACT (ECOG-ACRIN_8134) is investigating the role of inguino-pelvic chemo-radiotherapy for men with pN3 inguinal nodes but imaging negative pelvic nodes. CONCLUSIONS Radiotherapy has a well-defined role to play in treatment of squamous cell cancers of other sites, such as vulva, anal canal, uterine cervix and head and neck malignancies. Emerging data support the incorporation of radiotherapy into treatment paradigms for penile cancer.
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Affiliation(s)
- Juanita Crook
- University of British Columbia, BCCancer, 399 Royal Avenue, Kelowna, BC, Canada.
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19
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Wei L, Huang K, Han H, Liu RY. Human Papillomavirus Infection in Penile Cancer: Multidimensional Mechanisms and Vaccine Strategies. Int J Mol Sci 2023; 24:16808. [PMID: 38069131 PMCID: PMC10706305 DOI: 10.3390/ijms242316808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/19/2023] [Accepted: 11/23/2023] [Indexed: 12/18/2023] Open
Abstract
Penile cancer (PC) is a rare male malignant tumor, with early lymph node metastasis and poor prognosis. Human papillomavirus (HPV) plays a key role in the carcinogenesis of PC. This review aims to summarize the association between HPV infection and PC in terms of virus-host genome integration patterns (the disrupted regions in the HPV and PC genome), genetic alterations, and epigenetic regulation (methylation and microRNA modification) occurring in HPV and PC DNA, as well as tumor immune microenvironment reprogramming. In addition, the potential of HPV vaccination strategies for PC prevention and treatment is discussed. Understanding of the HPV-related multidimensional mechanisms and the application of HPV vaccines will promote rational and novel management of PC.
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Affiliation(s)
- Lichao Wei
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Kangbo Huang
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Hui Han
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
- Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou 510060, China
| | - Ran-yi Liu
- State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; (L.W.); (K.H.)
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20
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Wong LP, Alias H, Lim SH. Factors Influencing HPV Vaccine Intentions in Malaysian Men Who Have Sex with Men: A Cross-Sectional Study in Malaysia. Pathogens 2023; 12:1261. [PMID: 37887777 PMCID: PMC10610168 DOI: 10.3390/pathogens12101261] [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: 09/14/2023] [Revised: 10/09/2023] [Accepted: 10/16/2023] [Indexed: 10/28/2023] Open
Abstract
In the landscape of healthcare disparities and the marginalized status of men who have sex with men (MSM) in Malaysia, understanding the dynamics surrounding HPV vaccination is of paramount importance. The purpose of this study is to examine the knowledge and attitudes of MSM regarding HPV vaccination and to identify factors that may hinder or facilitate its uptake. The findings will contribute to the development of targeted interventions to promote HPV vaccination and reduce the burden of HPV-related health issues among Malaysian MSM. Between May 2019 and September 2022, an online cross-sectional survey was conducted to collect data through popular social media platforms targeting MSM in Malaysia. A multivariable logistic regression model was employed to investigate the associations between HPV vaccination intention and various influencing factors. Out of the total 411 respondents in the study, 266 (60.3%) indicated an intent to receive the HPV vaccination, falling under the categories of "certain to happen", "very likely", and "likely". The average knowledge score for participants was 6.82 (SD = 3.93, range 0-13) out of a total possible score of 13. In the multivariate logistic model, participants who identified themselves as bisexual (OR 6.93, 95% CI 2.35-20.41) and gay/homosexual (OR 4.36, 95% CI 1.66-11.42) showed a greater inclination to receive the HPV vaccine compared to heterosexual participants. High intent to be vaccinated for HPV infection was positively and significantly associated with a high level of knowledge (OR 1.79, 95% CI 1.09-2.95). In the multivariable model, there was no significant association between all variables of attitudes towards HPV infection and HPV vaccinations and the intention to receive HPV vaccination. Study participants reported a low level of susceptibility to HPV infection despite their perception that HPV infection is severe. Two-thirds of participants expected to encounter stigma in healthcare settings during future implementation of HPV vaccination programs. This study underscores the importance of improving HPV vaccine acceptance among Malaysian MSM due to the moderate acceptance level observed. In Malaysia, promoting HPV awareness, enhancing risk perception, and addressing stigma and sensitivity surrounding HPV vaccination may be beneficial in increasing the vaccination willingness among MSM.
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Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Sin How Lim
- Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
- Centre of Excellence for Research in AIDS (CERiA), Faculty of Medicine, Universiti Malaya, Kuala Lumpur 50603, Malaysia
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21
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Kusters JMA, Brouwer JGM, van Benthem BHB, Heijne JCM, Schim van der Loeff MF. Global Type-Specific Genital Human Papillomavirus Prevalence in Men, by Sexual Orientation: A Systematic Review and Meta-Analysis. J Infect Dis 2023; 228:1023-1032. [PMID: 37079383 PMCID: PMC10582913 DOI: 10.1093/infdis/jiad109] [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: 12/01/2022] [Revised: 03/16/2023] [Accepted: 04/18/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUND Knowledge on genital type-specific human papillomavirus (HPV) prevalence among men is important for prevention of HPV-related cancers and other diseases. Men who have sex with men (MSM) have higher anal prevalence than men who have sex with women only (MSW) but for genital HPV this is unclear. We performed a systematic review and meta-analysis of type-specific genital HPV prevalence among men, by sexual orientation. METHODS MEDLINE and Embase were used for searching publications reporting on male genital HPV prevalence with data from November 2011 onwards. A random-effects meta-analysis was conducted estimating pooled type-specific and grouped external genital and urethral HPV prevalence. Subgroup analyses were conducted for sexual orientation. RESULTS Twenty-nine studies were eligible. Of those, 13 studies reported prevalence among MSM, 5 among MSW, and 13 studies did not stratify by sexual orientation. The most common genotypes were HPV-6 and HPV-16 for both anatomical locations, although heterogeneity was high. HPV prevalence was similar among studies reporting on MSW, MSM, and men with unknown sexual orientation. CONCLUSIONS Genital HPV is common among men, with HPV-6 and HPV-16 being the most common genotypes. Type-specific HPV genital prevalence appears to be similar among MSM and MSW, which contrasts with earlier findings on anal HPV.
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Affiliation(s)
- Johannes M A Kusters
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
- Institute for Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | - Jesca G M Brouwer
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Birgit H B van Benthem
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Janneke C M Heijne
- Centre for Infectious Diseases Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Maarten F Schim van der Loeff
- Institute for Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
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22
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Mink JN, Khalmurzaev O, Pryalukhin A, Geppert CI, Lohse S, Bende K, Lobo J, Henrique R, Loertzer H, Steffens J, Jerónimo C, Wunderlich H, Heinzelbecker J, Bohle RM, Stöckle M, Matveev V, Hartmann A, Junker K. Evaluation of Prognostic Parameters to Identify Aggressive Penile Carcinomas. Cancers (Basel) 2023; 15:4748. [PMID: 37835442 PMCID: PMC10571727 DOI: 10.3390/cancers15194748] [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: 08/29/2023] [Revised: 09/11/2023] [Accepted: 09/20/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Advanced penile carcinoma is characterized by poor prognosis. Most data on prognostic factors are based on small study cohorts, and even meta-analyses are limited in patient numbers. Therefore, there is still a lack of evidence for clinical decisions. In addition, the most recent TNM classification is questionable; in line with previous studies, we found that it has not improved prognosis estimation. METHODS We evaluated 297 patients from Germany, Russia, and Portugal. Tissue samples from 233 patients were re-analyzed by two experienced pathologists. HPV status, p16, and histopathological parameters were evaluated for all patients. RESULTS Advanced lymph node metastases (N2, N3) were highly significantly associated with reductions in metastasis-free (MFS), cancer-specific (CS), and overall survival (OS) rates (p = <0.001), while lymphovascular invasion was a significant parameter for reduced CS and OS (p = 0.005; p = 0.007). Concerning the primary tumor stage, a significant difference in MFS was found only between pT1b and pT1a (p = 0.017), whereas CS and OS did not significantly differ between T categories. In patients without lymph node metastasis at the time of primary diagnosis, lymphovascular invasion was a significant prognostic parameter for lower MFS (p = 0.032). Histological subtypes differed in prognosis, with the worst outcome in basaloid carcinomas, but without statistical significance. HPV status was not associated with prognosis, either in the total cohort or in the usual type alone. CONCLUSION Lymphatic involvement has the highest impact on prognosis in penile cancer, whereas HPV status alone is not suitable as a prognostic parameter. The pT1b stage, which includes grading, as well as lymphovascular and perineural invasion in the T stage, seems questionable; a revision of the TNM classification is therefore required.
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Affiliation(s)
- Jan Niklas Mink
- Department of Urology and Paediatric Urology, Saarland University, 66421 Homburg, Germany (M.S.)
| | - Oybek Khalmurzaev
- Department of Urology and Paediatric Urology, Saarland University, 66421 Homburg, Germany (M.S.)
- Department of Urology, Federal State Budgetary Institution “N.N. Blokhin National Medical Research Center of Oncology”, Ministry of Health of the Russian Federation, Moscow 115478, Russia
| | - Alexey Pryalukhin
- Institute of Pathology, Saarland University Medical Centre, 66421 Homburg, Germany
| | | | - Stefan Lohse
- Institute of Virology, Saarland University, 66123 Homburg, Germany
| | - Kristof Bende
- Institute of Pathology, University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - João Lobo
- Department of Pathology and Cancer Biology and Epigenetics Group—Research Center, Portuguese Oncology Institute of Porto/Porto Comprehensive Cancer Center Raquel Seruca, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-513 Porto, Portugal; (J.L.); (R.H.)
| | - Rui Henrique
- Department of Pathology and Cancer Biology and Epigenetics Group—Research Center, Portuguese Oncology Institute of Porto/Porto Comprehensive Cancer Center Raquel Seruca, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-513 Porto, Portugal; (J.L.); (R.H.)
| | - Hagen Loertzer
- Clinic of Urology and Paediatric Urology, Westpfalz-Klinikum, 67655 Kaiserslautern, Germany
| | - Joachim Steffens
- Department of Urology and Paediatric Urology, St. Antonius Hospital, 52249 Eschweiler, Germany
| | - Carmen Jerónimo
- Department of Pathology and Cancer Biology and Epigenetics Group—Research Center, Portuguese Oncology Institute of Porto/Porto Comprehensive Cancer Center Raquel Seruca, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, 4050-513 Porto, Portugal; (J.L.); (R.H.)
| | - Heiko Wunderlich
- Clinic of Urology and Paediatric Urology, St. Georg Klinikum, 99817 Eisenach, Germany
| | - Julia Heinzelbecker
- Department of Urology and Paediatric Urology, Saarland University, 66421 Homburg, Germany (M.S.)
| | - Rainer M. Bohle
- Institute of Pathology, Saarland University Medical Centre, 66421 Homburg, Germany
| | - Michael Stöckle
- Department of Urology and Paediatric Urology, Saarland University, 66421 Homburg, Germany (M.S.)
| | - Vsevolod Matveev
- Department of Urology, Federal State Budgetary Institution “N.N. Blokhin National Medical Research Center of Oncology”, Ministry of Health of the Russian Federation, Moscow 115478, Russia
| | - Arndt Hartmann
- Institute of Pathology, University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Kerstin Junker
- Department of Urology and Paediatric Urology, Saarland University, 66421 Homburg, Germany (M.S.)
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23
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Tan Y, Wang Z, Xu M, Li B, Huang Z, Qin S, Nice EC, Tang J, Huang C. Oral squamous cell carcinomas: state of the field and emerging directions. Int J Oral Sci 2023; 15:44. [PMID: 37736748 PMCID: PMC10517027 DOI: 10.1038/s41368-023-00249-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/25/2023] [Accepted: 09/04/2023] [Indexed: 09/23/2023] Open
Abstract
Oral squamous cell carcinoma (OSCC) develops on the mucosal epithelium of the oral cavity. It accounts for approximately 90% of oral malignancies and impairs appearance, pronunciation, swallowing, and flavor perception. In 2020, 377,713 OSCC cases were reported globally. According to the Global Cancer Observatory (GCO), the incidence of OSCC will rise by approximately 40% by 2040, accompanied by a growth in mortality. Persistent exposure to various risk factors, including tobacco, alcohol, betel quid (BQ), and human papillomavirus (HPV), will lead to the development of oral potentially malignant disorders (OPMDs), which are oral mucosal lesions with an increased risk of developing into OSCC. Complex and multifactorial, the oncogenesis process involves genetic alteration, epigenetic modification, and a dysregulated tumor microenvironment. Although various therapeutic interventions, such as chemotherapy, radiation, immunotherapy, and nanomedicine, have been proposed to prevent or treat OSCC and OPMDs, understanding the mechanism of malignancies will facilitate the identification of therapeutic and prognostic factors, thereby improving the efficacy of treatment for OSCC patients. This review summarizes the mechanisms involved in OSCC. Moreover, the current therapeutic interventions and prognostic methods for OSCC and OPMDs are discussed to facilitate comprehension and provide several prospective outlooks for the fields.
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Affiliation(s)
- Yunhan Tan
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
- West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhihan Wang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Mengtong Xu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Bowen Li
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Zhao Huang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Siyuan Qin
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China
| | - Edouard C Nice
- Department of Biochemistry and Molecular Biology, Monash University, Clayton, VIC, Australia
| | - Jing Tang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
| | - Canhua Huang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, and West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, and Collaborative Innovation Center for Biotherapy, Chengdu, China.
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24
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Sanchez DF, Fernández-Nestosa MJ, Alemany L, Cañete-Portillo S, Lloveras B, Clavero O, Rodríguez I, Quint W, Muñoz N, de Sanjosé S, Bosch FX, Cubilla AL. Detection of variable genotypes in common human papillomavirus-associated invasive penile squamous cell carcinomas: a study of 177 human papillomavirus-positive cases. Hum Pathol 2023; 139:65-72. [PMID: 37429448 DOI: 10.1016/j.humpath.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/12/2023]
Abstract
Human papillomavirus (HPV) is detected in 30-50% of invasive penile carcinomas, and it is frequently associated with basaloid and warty morphological features. Based on this heterogeneity and different clinical behaviors, we hypothesized a variation in their HPV genotypic composition. To test this, we evaluated 177 HPV-positive cases: basaloid (114), warty-basaloid (28), and warty (condylomatous) (35) invasive carcinomas. HPV DNA detection and genotyping was performed using the SPF-10/DEIA/LiPA25 system. Nineteen HPV genotypes were detected. High-risk HPVs predominated (96%), and low-risk HPVs were rarely present. Most common genotype was HPV16 followed by HPVs 33 and 35. According to the genotypes identified, 93% of the cases would be covered with current vaccination programs. There was a significant variation in the distribution of HPV16 and non-HPV16 genotypes according to histological subtype. HPV16 was significantly frequent in basaloid (87%) and was less frequent in warty carcinomas (61%). This molecular difference, along with their distinctive macro-microscopic and prognostic features, makes basaloid and warty carcinomas unique. The gradual decreasing frequency of HPV16 demonstrated in basaloid, warty-basaloid, and warty carcinomas suggest that the basaloid cell, present in those types in decreasing proportions, may be responsible for the differences.
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Affiliation(s)
- Diego F Sanchez
- Instituto de Patología e Investigación, Asunción 1228, Paraguay; Translational Oncogenomics Group, Cancer Research UK Manchester Institute, University of Manchester, Manchester Cancer Research Centre, Manchester M20 4GJ, UK
| | | | - Laia Alemany
- Institut Català D'Oncologia, Barcelona 08908, Spain
| | | | | | - Omar Clavero
- Institut Català D'Oncologia, Barcelona 08908, Spain
| | - Ingrid Rodríguez
- Instituto de Patología e Investigación, Asunción 1228, Paraguay; Universidad Nacional de Asunción, San Lorenzo 2111, Paraguay
| | - Wim Quint
- DDL Diagnostic Laboratory, Rijswijk 2288, Netherlands
| | - Nubia Muñoz
- National Cancer Institute of Colombia, Bogotá 111511-110411001, Colombia
| | - Silvia de Sanjosé
- Barcelona Institute for Global Health (ISGlobal), Barcelona 08036, Spain
| | | | - Antonio L Cubilla
- Instituto de Patología e Investigación, Asunción 1228, Paraguay; Universidad Nacional de Asunción, San Lorenzo 2111, Paraguay.
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25
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Cao Z, Jiang H, He W, Pan H, Zhang C, Zhong X. The Potential Risk Compensation after Receiving HPV Vaccination among Men Who Have Sex with Men in Southwest China: A HAPA-Based Analysis. Vaccines (Basel) 2023; 11:1429. [PMID: 37766106 PMCID: PMC10538197 DOI: 10.3390/vaccines11091429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/29/2023] Open
Abstract
Background: men who have sex with men (MSM) are a high-risk group for human papillomavirus (HPV) infection, and the HPV vaccine is effective in preventing it. However, according to risk compensation theory, people may increase sexual risk behaviors after receiving HPV vaccination. Based on the Health Action Process Approach (HAPA), this study investigated the influencing factors to predict intention to reduce condom use (risk compensation intention) among MSM after taking HPV vaccination in southwest China. Methods: we conducted a cross-sectional study among 948 MSM in southwest China using a non-probability sampling method and an electronic questionnaire including sociodemographic characteristics, sexual risk behavior characteristics, HPV-related prevention behavior, and the HAPA scale. Confirmatory factor analysis was performed using a structural equation model. Results: among 948 MSM, the incidence rate of reducing the frequency of condom use was 14.1%. The structural equation model showed that self-efficacy (β = -0.378, p = 0.020) and positive outcome expectancy (β = 0.366, p < 0.05) had greater effects on behavioral intention, followed by negative outcome expectancy (β = -0.296, p < 0.05) and risk perception (β = -0.232, p < 0.05). Conclusions: risk compensation may not be a major barrier to receiving HPV vaccination among MSM. Nevertheless, the recognition of possible risk compensation is necessary to implement appropriate interventions to reduce the occurrence of risk compensation.
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Affiliation(s)
| | | | | | | | | | - Xiaoni Zhong
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (Z.C.); (H.J.); (W.H.); (H.P.); (C.Z.)
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26
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da Silva LL, Teles AM, Santos JMO, Souza de Andrade M, Medeiros R, Faustino-Rocha AI, Oliveira PA, dos Santos APA, Ferreira Lopes F, Braz G, Brito HO, da Costa RMG. Malignancy Associated with Low-Risk HPV6 and HPV11: A Systematic Review and Implications for Cancer Prevention. Cancers (Basel) 2023; 15:4068. [PMID: 37627099 PMCID: PMC10452364 DOI: 10.3390/cancers15164068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
High-risk human papillomavirus (HPV) is etiologically related to cervical cancer, other anogenital cancers and oropharyngeal carcinomas. Low-risk HPV, especially HPV6 and HPV11, cause genital warts and laryngeal papillomas. However, the accumulating data suggests that HPV6 and HPV11 may cause malignant lesions at non-cervical anatomic sites. This review aims to estimate the proportions of single and dual HPV6/11 infections in multiple cancers reported in the last 10 years in the Cochrane, Embasa and PubMed databases. Secondly, the genomes of HPV6/11 were compared with the most common high-risk genotype, HPV16, to determine the similarities and differences. A total of 11 articles were selected, including between one and 334 HPV+ cancer patients. The frequencies of single or dual HPV6/11 infections ranged between 0-5.5% for penile and 0-87.5% for laryngeal cancers and were null for vulvar, vaginal and oral cancers. The genomic similarities between HPV6/11 and HPV16 mainly involved the E7 gene, indicating a limited ability to block cell differentiation. The presence of single or dual HPV6/11 infections in variable proportions of penile and laryngeal cancers support the vaccination strategies that cover these genotypes, not only for preventing genital warts but also for cancer prevention. Other risk factors and co-carcinogens are likely to participate in epithelial carcinogenesis associated with low-risk HPV.
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Affiliation(s)
- Leandro Lima da Silva
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Amanda Mara Teles
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Animal Health, State University of Maranhão, São Luís 65099-110, MA, Brazil
| | - Joana M. O. Santos
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Marcelo Souza de Andrade
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
| | - Ana I. Faustino-Rocha
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Paula A. Oliveira
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
| | - Ana Paula Azevedo dos Santos
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Post-Graduate Program in Health Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil
| | - Fernanda Ferreira Lopes
- Post-Graduate Program in Odontology, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Geraldo Braz
- Post-Graduate Program in Computing Sciences, Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil;
| | - Haissa O. Brito
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
| | - Rui M. Gil da Costa
- Post-Graduate Program in Adult Health (PPGSAD), Federal University of Maranhão (UFMA), São Luís 65080-805, MA, Brazil (A.P.A.d.S.); (H.O.B.)
- Molecular Oncology and Viral Pathology Group, Portuguese Institute of Oncology of Porto Research Center (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Institute of Oncology of Porto (IPO-Porto)/Porto Comprehensive Cancer Center (Porto.CCC), 4200-072 Porto, Portugal
- Centre for the Research and Technology of Agro-Environmental and Biological Sciences (CITAB), University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal; (A.I.F.-R.)
- Inov4Agro—Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes and Alto Douro, 5000-801 Vila Real, Portugal
- Laboratory for Process Engineering, Environment, Biotechnology and Energy (LEPABE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
- Associate Laboratory in Chemical Engineering (ALiCE), Faculty of Engineering, University of Porto, 4200-465 Porto, Portugal
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Silva AJD, de Moura IA, da Gama MATM, Leal LRS, de Pinho SS, Espinoza BCF, dos Santos DL, Santos VEP, Sena MGAMD, Invenção MDCV, de Macêdo LS, de França Neto PL, de Freitas AC. Advancing Immunotherapies for HPV-Related Cancers: Exploring Novel Vaccine Strategies and the Influence of Tumor Microenvironment. Vaccines (Basel) 2023; 11:1354. [PMID: 37631922 PMCID: PMC10458729 DOI: 10.3390/vaccines11081354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/27/2023] [Accepted: 08/08/2023] [Indexed: 08/29/2023] Open
Abstract
The understanding of the relationship between immunological responses and cancers, especially those related to HPV, has allowed for the study and development of therapeutic vaccines against these neoplasias. There is a growing number of studies about the composition and influence of the tumor microenvironment (TME) in the progression or establishment of the most varied types of cancer. Hence, it has been possible to structure immunotherapy approaches based on therapeutic vaccines that are even more specific and directed to components of TME and the immune response associated with tumors. Among these components are dendritic cells (DCs), which are the main professional antigen-presenting cells (APCs) already studied in therapy strategies for HPV-related cancers. On the other hand, tumor-associated macrophages are also potential targets since the profile present in tumor infiltrates, M1 or M2, influences the prognosis of some types of cancer. These two cell types can be targets for therapy or immunomodulation. In this context, our review aims to provide an overview of immunotherapy strategies for HPV-positive tumors, such as cervical and head and neck cancers, pointing to TME immune cells as promising targets for these approaches. This review also explores the potential of immunotherapy in cancer treatment, including checkpoint inhibitors, cytokine immunotherapies, immunotherapy vaccines, and cell therapies. Furthermore, it highlights the importance of understanding the TME and its effect on the design and achievement of immunotherapeutic methods.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Antonio Carlos de Freitas
- Laboratory of Molecular Studies and Experimental Therapy—LEMTE, Department of Genetics, Federal University of Pernambuco, Recife 50670-901, Brazil; (A.J.D.S.); (I.A.d.M.); (M.A.T.M.d.G.); (L.R.S.L.); (S.S.d.P.); (B.C.F.E.); (D.L.d.S.); (V.E.P.S.); (M.G.A.M.D.S.); (M.D.C.V.I.); (L.S.d.M.); (P.L.d.F.N.)
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Mink JN, Khalmurzaev O, Pryalukhin A, Hölters S, Geppert C, Lohse S, Bende K, Lobo J, Henrique R, Loertzer H, Steffens J, Jerónimo C, Wunderlich H, Heinzelbecker J, Bohle R, Stöckle M, Matveev V, Hartmann A, Junker K. [Importance of HPV status and p16 for the prognosis of penile carcinoma]. Aktuelle Urol 2023; 54:274-284. [PMID: 37541236 DOI: 10.1055/a-2104-1270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/06/2023]
Abstract
BACKGROUND Penile cancer is a rare but often lethal tumour disease, especially in the metastatic stage. Most data on prognostic factors for penile cancer are based on small patient cohorts, and even meta-analyses are mostly limited in terms of patient numbers. There is a lack of sufficient parameters to predict the metastatic risk of these tumours. Furthermore, the role of the HPV status for the prognosis, and, in this regard, of p16INK4a is still unclear. MATERIAL AND METHODS In this study, 236 patients from an international multicentre cohort were analysed with regard to histological subtypes, HPV and p16 status, and other clinical parameters. The HPV status was only graded as HPV-positive if HPV was detected by PCR and the p16 status defined by immunochemistry was positive. The statistical analysis was carried out using the Kaplan-Meier method as well as the log-rank test and a univariable and multivariable analysis using the Cox regression model. RESULTS A positive HPV status was not a significant parameter for either metastasis-free (MFS), tumour-specific (CSS) or overall survival (OS). p16-positive tumours showed a significantly better MFS (p=0.026), which was also confirmed in the subgroup analysis of HPV-negative tumours (p=0.037) without differences in CSS or OS. In the usual type, there was also a trend towards an improved MFS, but without statistical significance (p=0.070). p16-positive tumours were associated with a highly significantly better MFS (hazard ratio 0.3; p=0.004) in the multivariable Cox regression, while patients with a pT1b tumour stage or advanced lymph node metastasis showed a significantly worse survival. In the multivariable analysis of HPV-negative tumours, p16 status was also confirmed as an independent predictor of MFS (Hazard ratio 0.2; p=0.007). CONCLUSION HPV status alone seems to be lacking prognostic relevance. In contrast, p16 status was confirmed as an independent prognostic factor. Thus, the expression of p16INK4a is associated with a significantly better MFS. Especially in HPV-negative tumours, the p16 status should be evaluated with regard to the prognostic value and thus also with a view to the treatment decision.
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Affiliation(s)
- Jan Niklas Mink
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
| | - Oybek Khalmurzaev
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
- Abteilung für Urologie, N N Blokhin NMRCO, Moskva, Russian Federation
| | - Alexey Pryalukhin
- Abteilung für Pathologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
- Institut für Pathologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - Sebastian Hölters
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
| | - Carol Geppert
- Institut für Pathologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Stefan Lohse
- Abteilung für Virologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
| | - Kristof Bende
- Institut für Pathologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - João Lobo
- Abteilung für Pathologie, IPO-PORTO, Porto, Portugal
| | - Rui Henrique
- Abteilung für Pathologie, IPO-PORTO, Porto, Portugal
| | - Hagen Loertzer
- Abteilung für Urologie und Kinderurologie, Westpfalz Klinikum Gmbh, Kaiserslautern, Deutschland
| | - Joachim Steffens
- Klinik für Urologie und Kinderurologie, St-Antonius-Hospital gGmbH, Eschweiler, Deutschland
| | - Carmen Jerónimo
- Abteilung für Pathologie, IPO-PORTO, Porto, Portugal
- Portuguese Oncology Institute of Porto, Research Center (CI-IPOP), Porto
| | - Heiko Wunderlich
- Abteilung für Urologie und Kinderurologie, St. Georg Klinikum Eisenach, Eisenach, Deutschland
| | - Julia Heinzelbecker
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
| | - Rainer Bohle
- Abteilung für Pathologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
| | - Michael Stöckle
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
| | - Vsevolod Matveev
- Abteilung für Urologie, N N Blokhin NMRCO, Moskva, Russian Federation
| | - Arndt Hartmann
- Institut für Pathologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Kerstin Junker
- Klinik für Urologie und Kinderurologie, Universitätsklinikum des Saarlandes und Medizinische Fakultät der Universität des Saarlandes, Homburg, Deutschland
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He Y, Mei J, Hao H, Liu F, Yi Y, Hu C, Zou F, Lu X. Selinexor demonstrates anti-tumor efficacy in paired patient-derived xenograft models and hydrogel-embedded histoculture drug sensitivity test of penile cancer. J Cancer Res Clin Oncol 2023; 149:6931-6941. [PMID: 36840755 DOI: 10.1007/s00432-023-04618-0] [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: 10/30/2022] [Accepted: 01/27/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Penile cancer is a rare malignancy with a poor prognosis, even with various treatment options. Considering the little progress in the study of the pathogenesis and treatment of penile cancer because of the lack of models that mimic the biological properties of the tumor, we have developed a patient-derived xenograft (PDX) model and paired hydrogel-embedded histoculture drug sensitivity test (HDST) to screen for drugs that can inhibit tumors. The increased expression of XPO1, as a key nuclear export protein involved in the transport of various tumor suppressors and cell cycle regulatory proteins, is associated with the prognosis of a variety of tumors [World J Uroly 27(2):141-150, 2009]. Selinexor is an inhibitor of XPO1, which can treat cancers, such as multiple myeloma, gastric cancer, triple-negative breast cancer, and non-small cell carcinoma [Transl Androl Urol 6(5):785-790, 2017; OncoTargets Therapy 13:6405-6416, 2020]. However, whether XPO1 inhibition has a role in penile cancer remains unknown. Therefore, this article used the PDX and HDST models to investigate whether the inhibition of XPO1 has an effect on penile cancer and its underlying mechanism. METHODS We used penile cancer tumor tissues to construct a PDX model of penile cancer and paired PDXE model and confirmed the consistency of PDX tumor tissues in source patients. Then, we assessed the ability of Selinexor to inhibit penile cancer tissues in vivo using a PDX model and in vitro by HDST. We also examined the potential mechanism of XPO1 action on penile cancer by IHC and TUNEL. Finally, we assessed the safety of the drug treatment by H&E and biochemical blood analysis. RESULTS Result showed that the penile cancer PDX model and patient penile cancer tissues were clinically consistent in morphological characteristics and protein expression. In addition, Selinexor could inhibit tumor growth in PDX models and HDST. We found that P53, P21 expression was upregulated; Cyclin D1 expression was downregulated, and apoptosis of tumor cells was increased in the Selinexor-treated PDX model. Moreover, it had no significant effect on liver, kidney, and cardiac function. CONCLUSION The PDX model of penile cancer was a powerful tool for penile cancer research and new drug development. It showed that Selinexor can effectively inhibit penile cancer in vitro and in vivo. In addition, XPO1 may affect P53, P21, and Cyclin D1 expression to regulate the growth and apoptosis of penile carcinoma.
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Affiliation(s)
- Yuanqiao He
- Center of Laboratory Animal Science, Nanchang University, Nanchang, 330031, China
- Jiangxi Province Key Laboratory of Laboratory Animal, Nanchang, 330031, China
- Nanchang Royo Biotechnology, Nanchang, 330006, China
| | - Jiaqi Mei
- The First Clinical Medical College, Nanchang University, Nanchang University, Nanchang, 330031, China
| | - Hua Hao
- Department of Pathology, School of Medicine, Yangpu Hospital, Tongji University, Shanghai, 200090, China
| | - Fanrong Liu
- Department of Pathology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Yun Yi
- Center of Biobank, The Second Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Chao Hu
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Fangxing Zou
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330000, China
| | - Xiongbing Lu
- Department of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, 330000, China.
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Grass GD, Ercan D, Obermayer AN, Shaw T, Stewart PA, Chahoud J, Dhillon J, Lopez A, Johnstone PAS, Rogatto SR, Spiess PE, Eschrich SA. An Assessment of the Penile Squamous Cell Carcinoma Surfaceome for Biomarker and Therapeutic Target Discovery. Cancers (Basel) 2023; 15:3636. [PMID: 37509297 PMCID: PMC10377392 DOI: 10.3390/cancers15143636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Penile squamous cell carcinoma (PSCC) is a rare malignancy in most parts of the world and the underlying mechanisms of this disease have not been fully investigated. About 30-50% of cases are associated with high-risk human papillomavirus (HPV) infection, which may have prognostic value. When PSCC becomes resistant to upfront therapies there are limited options, thus further research is needed in this venue. The extracellular domain-facing protein profile on the cell surface (i.e., the surfaceome) is a key area for biomarker and drug target discovery. This research employs computational methods combined with cell line translatomic (n = 5) and RNA-seq transcriptomic data from patient-derived tumors (n = 18) to characterize the PSCC surfaceome, evaluate the composition dependency on HPV infection, and explore the prognostic impact of identified surfaceome candidates. Immunohistochemistry (IHC) was used to validate the localization of select surfaceome markers. This analysis characterized a diverse surfaceome within patient tumors with 25% and 18% of the surfaceome represented by the functional classes of receptors and transporters, respectively. Significant differences in protein classes were noted by HPV status, with the most change being seen in transporter proteins (25%). IHC confirmed the robust surface expression of select surfaceome targets in the top 85% of expression and a superfamily immunoglobulin protein called BSG/CD147 was prognostic of survival. This study provides the first description of the PSCC surfaceome and its relation to HPV infection and sets a foundation for novel biomarker and drug target discovery in this rare cancer.
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Affiliation(s)
- George Daniel Grass
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Dalia Ercan
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Alyssa N Obermayer
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Timothy Shaw
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Paul A Stewart
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Jasreman Dhillon
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Alex Lopez
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Peter A S Johnstone
- Department of Radiation Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Silvia Regina Rogatto
- Department of Clinical Genetics, University Hospital of Southern Denmark-Vejle, Beriderbakken 4, 7100 Vejle, Denmark
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
| | - Steven A Eschrich
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
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31
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Chihu-Amparan L, Pedroza-Saavedra A, Gutierrez-Xicotencatl L. The Immune Response Generated against HPV Infection in Men and Its Implications in the Diagnosis of Cancer. Microorganisms 2023; 11:1609. [PMID: 37375112 DOI: 10.3390/microorganisms11061609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
Human papillomavirus (HPV) infection is associated with precancerous lesions and cancer of the genital tract both in women and men. The high incidence of cervical cancer worldwide focused the research on this infection mainly in women and to a lesser extent in men. In this review, we summarized epidemiological, immunological, and diagnostic data associated with HPV and cancer in men. We presented an overview of the main characteristics of HPV and infection in men that are associated with different types of cancer but also associated with male infertility. Men are considered important vectors of HPV transmission to women; therefore, identifying the sexual and social behavioral risk factors associated with HPV infection in men is critical to understand the etiology of the disease. It is also essential to describe how the immune response develops in men during HPV infection or when vaccinated, since this knowledge could help to control the viral transmission to women, decreasing the incidence of cervical cancer, but also could reduce other HPV-associated cancers among men who have sex with men (MSM). Finally, we summarized the methods used over time to detect and genotype HPV genomes, as well as some diagnostic tests that use cellular and viral biomarkers that were identified in HPV-related cancers.
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Affiliation(s)
- Lilia Chihu-Amparan
- Center of Research for Infection Diseases, National Institute of Public Health, Cuernavaca 62100, Morelos, Mexico
| | - Adolfo Pedroza-Saavedra
- Center of Research for Infection Diseases, National Institute of Public Health, Cuernavaca 62100, Morelos, Mexico
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Hrudka J, Prouzová Z, Kendall Bártů M, Hojný J, Čapka D, Zavillová N, Matěj R, Waldauf P. Immune cell infiltration, tumour budding, and the p53 expression pattern are important predictors in penile squamous cell carcinoma: a retrospective study of 152 cases. Pathology 2023:S0031-3025(23)00124-1. [PMID: 37316384 DOI: 10.1016/j.pathol.2023.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/12/2023] [Accepted: 03/28/2023] [Indexed: 06/16/2023]
Abstract
Penile squamous cell carcinoma (pSCC) is a rare malignancy with a slowly increasing incidence and variable prognosis. Regional lymph node involvement signifies poor prognosis but represents a late sign, and more prognostic markers for effective patient risk stratification are urgently needed. In this retrospective study, 152 tumour samples with formalin-fixed, paraffin-embedded tissue were analysed for traditional pathological variables, tumour budding, p53, p16, and mismatch repair proteins (MMR) immunohistochemistry. The density of tumour lymphocytic infiltrate was also determined, using subjective evaluation by two pathologists (brisk/non-brisk/absent) and also using the immunoscore method, which categorised the cohort into five immunoscore groups according to the number of CD3+ and CD8+ T-cells in both the tumour centre and tumour invasion front. Only one case (0.6%) was MMR-deficient. Tumour budding count ≥5 tumour buds/20× power field and non-brisk/absent lymphocytic infiltrate were significant negative predictors of both the overall survival (OS) and cancer-specific survival (CSS), whereas a low immunoscore was a significant marker of shorter OS but not CSS. Advanced pT stage (3+4) was a significant marker of shorter CSS but not OS. In the multivariate analysis, high-grade budding was a significant parameter if adjusted for the patient's age and associated variables, except for the pN stage. The lymphocytic infiltrate retained its prognostic significance if adjusted for age and associated variables. The negative prognostic significance of the previously described parameters (lymphatic, venous, and perineural invasion, regional lymph node metastasis, and p53 mutated profile) were confirmed in our study. Grade, histological subtype, and HPV status (as determined by p16 immunohistochemistry) showed, surprisingly, little or no prognostic significance.
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Affiliation(s)
- Jan Hrudka
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic.
| | - Zuzana Prouzová
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Michaela Kendall Bártů
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - Jan Hojný
- Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic
| | - David Čapka
- Department of Urology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Nicolette Zavillová
- Department of Urology, 3rd Faculty of Medicine of Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Radoslav Matěj
- Department of Pathology, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic; Department of Pathology, 1st Faculty of Medicine, Charles University, General University Hospital, Prague, Czech Republic; Department of Pathology and Molecular Medicine, 3rd Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Petr Waldauf
- Department of Anaesthesia and Intensive Care Medicine, 3rd Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, Czech Republic
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Lang B, Dong D, Zhao T, Zhong R, Qin H, Cao C, Wang Y, Liu T, Liang W, Tian X, Yan Y, Hu Z. A cross-sectional study of human papillomavirus genotype distribution and integration status in penile cancer among Chinese population. Virology 2023; 584:53-57. [PMID: 37244055 DOI: 10.1016/j.virol.2023.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/17/2023] [Accepted: 04/30/2023] [Indexed: 05/29/2023]
Abstract
Human papillomavirus (HPV) has been recognized as an important risk factor in penile cancer. This study aimed to investigate the HPV subtypes and integration status in Chinese patients. Samples were collected from 103 penile cancer patients aged 24-90 years between 2013 and 2019. We found that HPV infection rate was 72.8%, with 28.0% integration. The aging patients were more susceptible to HPV (p = 0.009). HPV16 was the most frequent subtype observed (52/75) and exhibited the highest frequency of integration events, with 11 out of 30 single infection cases showing integration positive. The HPV integrations sites in the viral genome were not randomly distributed, the breakpoints were enriched in the E1 gene (p = 0.006) but relatively scarce in L1, E6 and E7. Our research might provide some clues how HPV leads to the progression of penile cancer.
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Affiliation(s)
- Bin Lang
- Peking University Health Science Center - Macao Polytechnic University Nursing Academy, Macao Polytechnic University, Macao 999078, China.
| | - Dirong Dong
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Donghu 169th Road, Wuchang District, Wuhan, 430062, Hubei, China.
| | - Tong Zhao
- Academician Expert Workstation, Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
| | - Ruolei Zhong
- Department of Hepatobiliary Surgery, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan, 430014, China.
| | - Huimin Qin
- Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University, Donghu 169th Road, Wuchang District, Wuhan, 430062, Hubei, China.
| | - Chen Cao
- Academician Expert Workstation, Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
| | - Yuyan Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510000, China.
| | - Ting Liu
- Academician Expert Workstation, Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
| | - Wenjia Liang
- Academician Expert Workstation, Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
| | - Xun Tian
- Academician Expert Workstation, Department of Obstetrics and Gynecology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China.
| | - Yongji Yan
- Department of Urology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, 100000, China.
| | - Zheng Hu
- Department of Obstetrics and Gynecology, Women and Children's Hospital Affiliated to Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Department of Radiation a nd Medical Oncology Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Key Laboratory of Tumor Biological Behaviors, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China; Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China.
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Gordon J, Bail J. Cancer Prevention Begins in Middle School: The Personal Advantages of HPV Immunization in Males. NASN Sch Nurse 2023; 38:114-120. [PMID: 36691362 DOI: 10.1177/1942602x221151134] [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: 04/21/2023]
Abstract
The human papillomavirus (HPV) is the most common sexually transmitted infection in the United States despite most cases being preventable by vaccination. HPV vaccine efficacy varies in relationship to when the vaccine is administered, with greater efficacy obtained if administered prior to sexual debut. Historically, this vaccine was created to protect women from cervical cancer. As scientific knowledge of HPV-related cancers has advanced, it has become evident that HPV vaccination is a priority for both genders. HPV is known to contribute to male cancers of the mouth, throat, anus, and penis, as well as causing genital warts. This article aims to explain the benefits of HPV immunization for the gender the farthest from meeting vaccination goals, boys, and young men. This article expounds on the school nurses' role in promoting vaccination to prevent HPV infection and the sequela of related cancers.
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Affiliation(s)
- Jenny Gordon
- Family Nurse Practitioner, PhD Student, Thelen Family Medicine, Fayetteville, TN
- University of Tennessee Southern Campus Clinic, Pulaski, TN
- University of Alabama Huntsville Joint PhD Program with the University of Alabama, Huntsville, AL
| | - Jennifer Bail
- Assistant Professor of Nursing, University of Alabama in Huntsville College of Nursing, Huntsville, AL
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Jeanne-Julien A, Bouchot O, De Vergie S, Branchereau J, Perrouin-Verbe MA, Rigaud J. Long-term oncological results in penile cancer treated by inguinal lymphadenectomy. World J Urol 2023:10.1007/s00345-023-04390-3. [PMID: 37039906 DOI: 10.1007/s00345-023-04390-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/28/2023] [Indexed: 04/12/2023] Open
Abstract
PURPOSE In 95% of cases, penile cancer is a squamous cell carcinoma whose specificity is lymphatic spread with the inguinal lymph nodes as the first relay route. Inguinal lymph node dissection is a primordial part of the treatment. The objective was to assess the oncological results of inguinal lymph node dissection in penile cancer at our centre. METHODS We retrospectively included all patients having undergone inguinal lymph node dissection at our centre between 1 January 2004 and 1 January 2020 for the treatment of penile cancer. Patients for whom lymphadenopathy was palliative were excluded. Depending on indications, the procedures consisted in either dynamic sentinel node biopsy, modified lymphadenectomy or radical lymphadenectomy. All cancers were reclassified using the 2016 TNM classification system. Survival was analysed according to the Kaplan-Meier method. RESULTS 242 inguinal lymph node dissections were performed in 122 patients. There were 71 pN0 (58%), 9 pN1 (7%), 4 pN2 (3%) and 38 pN3 (31%). Mean follow-up was 51 ± 45 months. The 3-year recurrence-free survival rate was 76% in pN0 patients and 17% in pN3 patients. The 5-year specific and overall survival rates were, respectively, 82% and 73% for pN0 stages, and 14% and 17% for pN3 stages. Extracapsular extension on an inguinal lymphadenopathy appeared as a highly negative prognostic factor. CONCLUSION Inguinal lymph node dissection is essential in the treatment of penile cancer. Recurrence-free, specific and overall survival are closely linked to the lymph node stage. Extracapsular extension and pelvic lymph node invasion are highly negative prognostic factors.
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Affiliation(s)
- Antoine Jeanne-Julien
- Clinique Urologique, Hôpital Hôtel Dieu, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France.
| | - Olivier Bouchot
- Clinique Urologique, Hôpital Hôtel Dieu, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Stéphane De Vergie
- Clinique Urologique, Hôpital Hôtel Dieu, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | - Julien Branchereau
- Clinique Urologique, Hôpital Hôtel Dieu, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
| | | | - Jérôme Rigaud
- Clinique Urologique, Hôpital Hôtel Dieu, CHU de Nantes, 1 Place Alexis Ricordeau, 44093, Nantes, France
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Edwards SK, Bunker CB, van der Snoek EM, van der Meijden WI. 2022 European guideline for the management of balanoposthitis. J Eur Acad Dermatol Venereol 2023; 37:1104-1117. [PMID: 36942977 DOI: 10.1111/jdv.18954] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 02/01/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND This guideline is an update to the 2014 edition of the European guideline for the management of balanoposthitis. Balanoposthitis describes inflammation of the glans penis and prepuce and is caused by a range of disparate conditions including infection, dermatoses and premalignancy. OBJECTIVE The main objectives of this guideline are to aid recognition of the symptoms and signs and complications of penile skin conditions and to offer recommendations on the diagnostic tests and treatment for a selected group of these conditions. METHODS The previous guideline was updated following a literature review and priority was given to randomized controlled trial and systematic review evidence. RESULTS The updated guideline includes amended management for infective balanitis to provide clear guidance for Group A streptococcal infections, management of on going Lichen sclerosus (to include circumcision and supportive management to reduce the recurrence of genital herpes and warts), additional regimens for Zoonoid change, use of calcineurin inhibitors in management and risk of premalignancy and change of nomenclaturefrom Premalignant conditions to Penile Intraepithelial neoplasia (PeIN). CONCLUSION Balanoposthitis has a widerange of causes high quality evidence specific to the management of penile disease is not available for all the conditions described.
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Li Z, Liu P, Wang Z, Zhang Z, Chen Z, Chu R, Li G, Han Q, Zhao Y, Li L, Miao J, Kong B, Song K. Prevalence of human papillomavirus DNA and p16 INK4a positivity in vulvar cancer and vulvar intraepithelial neoplasia: a systematic review and meta-analysis. Lancet Oncol 2023; 24:403-414. [PMID: 36933562 DOI: 10.1016/s1470-2045(23)00066-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) DNA and p16INK4a positivity have crucial roles in the pathogenesis of vulvar cancer and vulvar intraepithelial neoplasia. We aimed to examine the pooled prevalence of HPV DNA and p16INK4a positivity in vulvar cancer and vulvar intraepithelial neoplasia worldwide. METHODS In this systematic review and meta-analysis, we searched PubMed, Embase, and the Cochrane Library databases for studies published between Jan 1, 1986, and May 6, 2022, that reported the prevalence of HPV DNA, or p16INK4a positivity, or both, in histologically verified vulvar cancer or vulvar intraepithelial neoplasia. Studies on a minimum of five cases were included. Study-level data were extracted from the published studies. Random effect models were used to examine the pooled prevalence of HPV DNA and p16INK4a positivity in both vulvar cancer and vulvar intraepithelial neoplasia, which were further investigated using stratified analyses by histological subtype, geographical region, HPV DNA or p16INK4a detection method, tissue sample type, HPV genotype, publication year, and age at diagnosis. Additionally, meta-regression was applied to explore sources of heterogeneity. FINDINGS We retrieved 6393 search results, of which 6233 were excluded for being duplicates or after application of our inclusion and exclusion criteria. We also identified two studies from manual searches of references lists. 162 studies were eligible for inclusion in the systematic review and meta-analysis. The prevalence of HPV in vulvar cancer (91 studies; n=8200) was 39·1% (95% CI 35·3-42·9) and in vulvar intraepithelial neoplasia (60 studies; n=3140) was 76·1% (70·7-81·1). The most predominant HPV genotype in vulvar cancer was HPV16 (78·1% [95% CI 73·5-82·3]), followed by HPV33 (7·5% [4·9-10·7]). Similarly, HPV16 (80·8% [95% CI 75·9-85·2]) and HPV33 (6·3% [3·9-9·2]) were also the most two predominant HPV genotypes in vulvar intraepithelial neoplasia. The distribution of type-specific HPV genotypes in vulvar cancer among geographical regions was different, with HPV16 varying between regions, showing a high prevalence in Oceania (89·0% [95% CI 67·6-99·5]) and a low prevalence in South America (54·3% [30·2-77·4]). The prevalence of p16INK4a positivity in patients with vulvar cancer was 34·1% (95% CI 30·9-37·4; 52 studies; n=6352), and it was 65·7% (52·5-77·7; 23 studies; n=896) in patients with vulvar intraepithelial neoplasia. Furthermore, among patients with HPV-positive vulvar cancer, p16INK4a positivity prevalence was 73·3% (95% CI 64·7-81·2), compared with 13·8% (10·0-18·1) in HPV-negative vulvar cancer. The prevalence of double positivity for HPV and p16INK4a was 19·6% (95% CI 16·3-23·0) in vulvar cancer and 44·2% (26·3-62·8) in vulvar intraepithelial neoplasia. Most analyses had large heterogeneity (I2>75%). INTERPRETATION The high prevalence of HPV16 and HPV33 in vulvar cancer and vulvar intraepithelial neoplasia emphasised the importance of nine-valent HPV vaccination in preventing vulvar neoplasm. Additionally, this study highlighted the potential clinical significance of double positivity for HPV DNA and p16INK4a in vulvar neoplasm. FUNDING Taishan Scholar Youth Project of Shandong Province, China.
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Affiliation(s)
- Zhuang Li
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Penglin Liu
- Department of Gynecological Oncology, Beijing Obstetrics and Gynaecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Ziying Wang
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zhaoyang Zhang
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Zhongshao Chen
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Ran Chu
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Guiju Li
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Qiuyue Han
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Yong Zhao
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Li Li
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Jinwei Miao
- Department of Gynecological Oncology, Beijing Obstetrics and Gynaecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing, China
| | - Beihua Kong
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Kun Song
- Department of Obstetrics and Gynaecology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
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European Association of Urology-American Society of Clinical Oncology Collaborative Guideline on Penile Cancer: 2023 Update. Eur Urol 2023; 83:548-560. [PMID: 36906413 DOI: 10.1016/j.eururo.2023.02.027] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 02/25/2023] [Indexed: 03/11/2023]
Abstract
CONTEXT Penile cancer is a rare disease but has a significant impact on quality of life. Its incidence is increasing, so it is important to include new and relevant evidence in clinical practice guidelines. OBJECTIVE To provide a collaborative guideline that offers worldwide physician and patient guidance for the management of penile cancer. EVIDENCE ACQUISITION Comprehensive literature searches were performed for each section topic. In addition, three systematic reviews were conducted. Levels of evidence were assessed, and a strength rating for each recommendation was assigned according to the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) methodology. EVIDENCE SYNTHESIS Penile cancer is a rare disease but its global incidence is increasing. Human papillomavirus (HPV) is the main risk factor for penile cancer and pathology should include an assessment of HPV status. The main aim of primary tumour treatment is complete tumour eradication, which has to be balanced against optimal organ preservation without compromising oncological control. Early detection and treatment of lymph node (LN) metastasis is the main determinant of survival. Surgical LN staging with sentinel node biopsy is recommended for patients with a high-risk (≥pT1b) tumour with cN0 status. While (inguinal) LN dissection remains the standard for node-positive disease, multimodal treatment is needed in patients with advanced disease. Owing to a lack of controlled trials and large series, the levels of evidence and grades of recommendation are low in comparison to those for more common diseases. CONCLUSIONS This collaborative penile cancer guideline provides updated information on the diagnosis and treatment of penile cancer for use in clinical practice. Organ-preserving surgery should be offered for treatment of the primary tumour when feasible. Adequate and timely LN management remains a challenge, especially in advanced disease stages. Referral to centres of expertise is recommended. PATIENT SUMMARY Penile cancer is a rare disease that significantly impacts quality of life. While the disease can be cured in most cases without lymph node involvement, management of advanced disease remains challenging. Many unmet needs and unanswered questions remain, underlining the importance of research collaborations and centralisation of penile cancer services.
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Hongo T, Yamamoto H, Kuga R, Komune N, Miyazaki M, Tsuchihashi NA, Noda T, Matsumoto N, Oda Y, Nakagawa T. High-risk HPV-related squamous cell carcinoma in the temporal bone: a rare but noteworthy subtype. Virchows Arch 2023; 482:539-550. [PMID: 36705751 DOI: 10.1007/s00428-023-03497-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/12/2023] [Accepted: 01/17/2023] [Indexed: 01/28/2023]
Abstract
High-risk human papillomavirus (HPV) is a risk factor for the development of several head and neck squamous cell carcinomas (SCCs). However, there have been few reports of high-risk HPV infection in temporal bone squamous cell carcinomas (TBSCCs), and thus the prevalence and clinicopathologic significance of high-risk HPV in TBSCCs are still unclear. We retrospectively collected 131 TBSCCs and analyzed them for transcriptionally active high-risk HPV infection using messenger RNA in situ hybridization; we also assessed the utility of p16-immunohistochemistry (IHC) and Rb-IHC to predict HPV infection. Eighteen (13.7%) of the 131 TBSCCs were positive for p16-IHC, and five of them were positive for high-risk HPV infection (the estimated high-risk HPV positivity rate was 3.8% [5/131]). Interestingly, all five HPV-positive patients were male and had TBSCC on the right side. In the p16-IHC+/HPV+ cases (n = 5), the Rb-IHC showed a partial loss pattern (n = 4) or complete loss pattern (n = 1). In contrast, all p16-IHC-negative cases (n = 113) showed an Rb-IHC preserved pattern. The positive predictive value (PPV) of p16-IHC positivity for high-risk HPV infection was low at 27.8%, while the combination of p16-IHC+/Rb-IHC partial loss pattern showed excellent reliability with a PPV of 100%. The prognostic significance of high-risk HPV infection remained unclear. High-risk HPV-related TBSCC is an extremely rare but noteworthy subtype.
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Affiliation(s)
- Takahiro Hongo
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Hidetaka Yamamoto
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryosuke Kuga
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noritaka Komune
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan.
| | - Masaru Miyazaki
- Department of Otorhinolaryngology, Fukuoka University Hospital and School of Medicine, Fukuoka, Japan
| | - Nana Akagi Tsuchihashi
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Teppei Noda
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Nozomu Matsumoto
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Yoshinao Oda
- Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takashi Nakagawa
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-Ku, Fukuoka, 812-8582, Japan
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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.
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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
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The Evolving Landscape of Viral, Immune, and Molecular Biomarkers in Penile Cancer. Urol Clin North Am 2023; 50:145-150. [DOI: 10.1016/j.ucl.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Morbidity and risk factors for complications of inguinal lymph node dissection in penile cancer. World J Urol 2023; 41:109-118. [PMID: 36208315 DOI: 10.1007/s00345-022-04169-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/23/2022] [Indexed: 01/21/2023] Open
Abstract
PURPOSE To assess the morbidity of inguinal lymph node dissection (ILND) in penile cancer, then to compare this morbidity with that of ILND performed in the context of skin cancer treatment. METHODS We retrospectively included all patients having undergone ILND between 1 January 2004 and 31 December 2019 in our centre's urology department in the context of treatment of penile cancer or skin cancer. Postoperative complications were reported in accordance with the Clavien-Dindo classification system. RESULTS Two hundred forty-two ILNDs were performed in 122 patients with penile cancer and 56 ILNDs were performed in 56 patients with skin cancer. The most common early complication was postoperative fluid collection (lymphocele or haematoma), which complicated 44% of ILNDs overall and 60% of radical lymphadenectomies. The most common late complication was leg lymphoedema, found in up to 36% of radical lymphadenectomies. Major complications (grade ≥ III) were very rare (4% of radical lymphadenectomies). Radical lymphadenectomies resulted in significantly more cases of postoperative fluid collection, skin necrosis and dehiscence, as well as leg lymphoedema, than modified lymphadenectomy techniques. Two factors significantly increasing postoperative morbidity were demonstrated: ASA score = 3 (OR = 3.09) and operating time (OR = 1.01). CONCLUSION ILNDs are morbid surgical procedures for which the indications must be well defined. However, the complications are almost exclusively minor, for a major oncological benefit.
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Drevinskaite M, Patasius A, Kincius M, Jonušas J, Ladukas A, Jievaltas M, Kairevice L, Smailyte G. Incidence, mortality and survival trends of penile cancer in Lithuania 1998-2017. Front Oncol 2023; 13:1124101. [PMID: 37213282 PMCID: PMC10196467 DOI: 10.3389/fonc.2023.1124101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/24/2023] [Indexed: 05/23/2023] Open
Abstract
Background and objectives The aim of this study was to analyse trends in penile cancer incidence, mortality, and relative survival in Lithuania during the period of 1998-2017. Materials and methods The study was based on all cases of penile cancer reported to the Lithuanian Cancer Registry between 1998 and 2017. Age-specific rates standardized rates were calculated, using the direct method (World standard population). The Joinpoint regression model was used to provide estimated average annual percentage change (AAPC). One-year and five-year relative survival estimates were calculated using period analysis. Relative survival was calculated as the ratio of the observed survival of cancer patients and the expected survival of the underlying general population. Results During the study period, the age-standardized incidence rate of penile cancer varied between 0.72 and 1.64 per 100 000, with AAPC 0.9% (95% CI -0.8-2.7). The mortality rate of penile cancer in Lithuania during this period varied from 0.18 to 0.69 per 100 000, with AAPC of -2.6% (95% CI -5.3-0.3). Relative one-year survival of patients, diagnosed with penile cancer improved over the time from 75.84% in period 1998-2001 to 89.33% in period 2014-2017. Relative five-year survival rate of patients, diagnosed with penile cancer changed from 55.44% in period 1998-2001 to 72.90% in period 2014-2017. Conclusions The incidence rates of penile cancer showed an increasing trend, while mortality rates were decreasing in Lithuania during 1998-2017. One-year and five-year relative survival increased, however, it does not reach the highest scores of Northern European countries.
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Affiliation(s)
- Mingaile Drevinskaite
- Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania
- *Correspondence: Mingaile Drevinskaite,
| | - Ausvydas Patasius
- Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Marius Kincius
- Laboratory of Clinical Oncology, National Cancer Institute, Vilnius, Lithuania
| | - Justinas Jonušas
- Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania
- The Clinic of Internal Diseases, Family Medicine and Oncology, Faculty of Medicine, Vilnius Universitys, Vilnius, Lithuania
| | - Adomas Ladukas
- Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania
| | - Mindaugas Jievaltas
- Urology Department, Lithuanian University of Health Sciences, Medicine Academy, Kaunas, Lithuania
| | - Laura Kairevice
- Department of Oncology and Hematology, Institute of Oncology, Medical Faculty, Lithuanian University of Health Science, Kaunas, Lithuania
| | - Giedre Smailyte
- Laboratory of Cancer Epidemiology, National Cancer Institute, Vilnius, Lithuania
- Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Gamboa-Hoil SI. Human papillomavirus in men. Rev Int Androl 2023; 21:100325. [PMID: 36257902 DOI: 10.1016/j.androl.2021.09.001] [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: 03/11/2021] [Revised: 06/11/2021] [Accepted: 09/19/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To describe the clinical behavior of human papillomavirus in men. MATERIALS AND METHODS Current international literature was reviewed to describe the clinical behavior of human papillomavirus in men. RESULTS Internationally, the overall prevalence of HPV DNA is 50.8%, HPV considered high risk are 14 types. Prevalence of HPV DNA in invasive penile cancer ranges from 33.1% to 47%. HPV-16 has been the most frequent (68.3%), followed by HPV-6 (8.1%) and HPV-18 (6.9%). Positive HPV is described as an independent prognostic factor for cancer-specific survival. CONCLUSION It is not clear why HPV infection has a predilection in specific areas of the genital tract. However, it is important to note that there are factors that increase the risk of HPV infection.
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Penile intraepithelial neoplasia: Distribution of subtypes, HPV genotypes and p16 INK4a in 84 international cases. Hum Pathol 2023; 131:1-8. [PMID: 36427594 DOI: 10.1016/j.humpath.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/16/2022] [Accepted: 11/16/2022] [Indexed: 11/25/2022]
Abstract
There are few pathologic or molecular studies of penile precancerous lesions, and the majority refers to lesions associated with invasive carcinomas. Penile Intraepithelial Neoplasia (PeIN) is classified in two morphologically and distinctive molecular groups, non-HPV and HPV-related with special subtypes. The primary purpose of this international series was to classify PeIN morphologically, detect HPV genotypes and determine their distribution according to PeIN subtypes. A secondary aim was to evaluate the p16INK4a immunostaining as a possible HPV surrogate for high-risk HPV infection in penile precancerous lesions. Samples consisted of 84 PeIN cases, part of a retrospective cross-sectional analysis of 1095 penile carcinomas designed to estimate the HPV DNA prevalence in penile cancers using PCR and p16INK4a immunostaining. Penile Intraepithelial Neoplasia (PeIN) was classified in HPV-related (basaloid, warty-basaloid, warty, hybrid, and mixed subtypes) and non-HPV-related (differentiated), the former being the most frequent. PeIN subtypes were differentiated (non-HPV-related) and basaloid, warty-basaloid, warty, hybrid and mixed (HPV-related). Basaloid PeIN was the most commonly diagnosed subtype, and HPV16 was the most frequent HPV genotype detected. Warty-basaloid and warty PeIN showed a more heterogeneous genotypic composition. Most HPV genotypes were high-risk but low-risk HPV genotypes were also present in a few cases (4%). A single HPV genotype was detected in 82% of HPV positive cases. In contrast, multiple genotypes were detected in the remaining 18% of cases. The findings in this study support the paradigm that penile in situ neoplasia, like its invasive counterparts, is HPV dependent or independent and has distinctive morphological subtypes readily identified in routine practice. Considering that HPV16 is clearly the predominant type, and that the three available vaccines have HPV16, all of them will be suitable for vaccination programs; the price of the vaccines will be probably the main determinant to choose the vaccine.
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[Verrucous exophytic tumor of the glans penis]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:195-198. [PMID: 36512101 PMCID: PMC9981705 DOI: 10.1007/s00105-022-05085-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/16/2022] [Indexed: 12/15/2022]
Abstract
A 59-year-old man presented with a growing tumor on the glans penis, which we excised. Histologically, there was an acanthotic epidermis under which the papillary dermis was filled with foamy macrophages, best seen in a CD 68 stain. Verruciform xanthoma was diagnosed. Knowledge of this benign diagnosis may prevent an overly hasty, aggressive approach, since the differential diagnosis of penile carcinoma requires much more radical therapy, and mutilating penile surgery is associated with considerable psychosexual distress for patients.
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O'Brien JS, McVey A, Kelly BD, Chee J, Lawrentschuk N. Recent developments in the diagnosis and management of N1 penile cancer. Curr Opin Urol 2023; 33:64-69. [PMID: 36444651 DOI: 10.1097/mou.0000000000001058] [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: 11/30/2022]
Abstract
PURPOSE OF REVIEW This article presents a critical review of the current literature to provide a brief update on the contemporary advances in diagnosing and managing N1 penile cancer. RECENT FINDINGS Penile squamous cell carcinoma (pSCC) has evolved from being an orphan field for cancer innovation. Advances in the understanding tumour biology have enabled sophisticated diagnostics and predictive modelling to better characterize inguinal disease. Minimally invasive inguinal lymph node dissection is emerging as a technique that reduces morbidity while maintaining oncological safety. Furthermore, robust clinical trials are underway ,which will provide level one evidence to guide treatment decisions. Exciting advances in the field of immune-oncology offer promise as adjuvant therapies. International collaboration and centralisation of care will be essential to driving translational research and equitable evidence-based care. SUMMARY Improving outcomes for men with pSCC remains a global challenge. Radical inguinal lymph node dissection remains the gold standard for diagnosing and curing N1 disease. Although many promising developments are on the horizon, high-level evidence is required to guide therapy.
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Affiliation(s)
- Jonathan S O'Brien
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, The Royal Melbourne Hospital
- Prostate Cancer Theranostics and Imaging Centre of Excellence, Peter MacCallum Cancer Centre
| | - Aoife McVey
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
| | - Brian D Kelly
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, Eastern Health
| | - Justin Chee
- MURAC Health, East Melbourne
- Department of Urology, Alfred Health
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre
- Sir Peter MacCallum Department of Oncology, The University of Melbourne
- Department of Urology, The Royal Melbourne Hospital
- EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Victoria, Australia
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Niforatos S, Sandhu M, Siegenthaler A, Bordas J, Loon T, Akhtar K. Dyspnea Secondary to Mediastinal Mass: A Rare Presentation of Metastatic Penile Squamous Cell Carcinoma. J Investig Med High Impact Case Rep 2023; 11:23247096231205348. [PMID: 37811886 PMCID: PMC10563466 DOI: 10.1177/23247096231205348] [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: 07/06/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 10/10/2023] Open
Abstract
Penile squamous cell carcinoma is a rare diagnosis in the United States; however, the incidence is significantly higher in developing countries. This cancer is categorized into human papilloma virus (HPV)-associated and independent disease. In this article, we present a rare case of HPV-independent penile squamous cell carcinoma. Our patient was a 75-year-old Caucasian male who initially presented with a penile ulcer which was managed with partial penectomy and adjuvant chemotherapy. The patient was monitored on surveillance and did not pursue lymph node dissection. He was noted to have recurrence with metastatic disease 5 years after his initial presentation. Due to the aggressive nature of his disease, the patient was admitted to the hospital and treated with chemotherapy and immunotherapy.
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Affiliation(s)
| | - Michael Sandhu
- State University of New York Upstate Medical University, Syracuse, USA
| | | | - Jozsef Bordas
- State University of New York Upstate Medical University, Syracuse, USA
| | - Taylor Loon
- State University of New York Upstate Medical University, Syracuse, USA
| | - Komal Akhtar
- State University of New York Upstate Medical University, Syracuse, USA
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Hewavisenti RV, Arena J, Ahlenstiel CL, Sasson SC. Human papillomavirus in the setting of immunodeficiency: Pathogenesis and the emergence of next-generation therapies to reduce the high associated cancer risk. Front Immunol 2023; 14:1112513. [PMID: 36960048 PMCID: PMC10027931 DOI: 10.3389/fimmu.2023.1112513] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/03/2023] [Indexed: 03/09/2023] Open
Abstract
Human papillomavirus (HPV), a common sexually transmitted virus infecting mucosal or cutaneous stratified epithelia, is implicated in the rising of associated cancers worldwide. While HPV infection can be cleared by an adequate immune response, immunocompromised individuals can develop persistent, treatment-refractory, and progressive disease. Primary immunodeficiencies (PIDs) associated with HPV-related disease include inborn errors of GATA, EVER1/2, and CXCR4 mutations, resulting in defective cellular function. People living with secondary immunodeficiency (e.g. solid-organ transplants recipients of immunosuppression) and acquired immunodeficiency (e.g. concurrent human immunodeficiency virus (HIV) infection) are also at significant risk of HPV-related disease. Immunocompromised people are highly susceptible to the development of cutaneous and mucosal warts, and cervical, anogenital and oropharyngeal carcinomas. The specific mechanisms underlying high-risk HPV-driven cancer development in immunocompromised hosts are not well understood. Current treatments for HPV-related cancers include surgery with adjuvant chemotherapy and/or radiotherapy, with clinical trials underway to investigate the use of anti-PD-1 therapy. In the setting of HIV co-infection, persistent high-grade anal intraepithelial neoplasia can occur despite suppressive antiretroviral therapy, resulting in an ongoing risk for transformation to overt malignancy. Although therapeutic vaccines against HPV are under development, the efficacy of these in the setting of PID, secondary- or acquired- immunodeficiencies remains unclear. RNA-based therapeutic targeting of the HPV genome or mRNA transcript has become a promising next-generation therapeutic avenue. In this review, we summarise the current understanding of HPV pathogenesis, immune evasion, and malignant transformation, with a focus on key PIDs, secondary immunodeficiencies, and HIV infection. Current management and vaccine regimes are outlined in relation to HPV-driven cancer, and specifically, the need for more effective therapeutic strategies for immunocompromised hosts. The recent advances in RNA-based gene targeting including CRISPR and short interfering RNA (siRNA), and the potential application to HPV infection are of great interest. An increased understanding of both the dysregulated immune responses in immunocompromised hosts and of viral persistence is essential for the design of next-generation therapies to eliminate HPV persistence and cancer development in the most at-risk populations.
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Affiliation(s)
- Rehana V. Hewavisenti
- Immunovirology and Pathogenesis Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
| | - Joshua Arena
- Immunovirology and Pathogenesis Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
- UNSW RNA Institute, The University of New South Wales, Sydney, NSW, Australia
| | - Chantelle L. Ahlenstiel
- Immunovirology and Pathogenesis Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
- UNSW RNA Institute, The University of New South Wales, Sydney, NSW, Australia
| | - Sarah C. Sasson
- Immunovirology and Pathogenesis Program, The Kirby Institute, The University of New South Wales, Sydney, NSW, Australia
- *Correspondence: Sarah C. Sasson,
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Tekin B, Guo R, Cheville JC, Canete-Portillo S, Sanchez DF, Fernandez-Nestosa MJ, Dasari S, Menon S, Herrera-Hernandez L, Jimenez RE, Erickson LA, Cubilla AL, Gupta S. Penile squamous cell carcinoma exclusive to the shaft, with a proposal for a novel staging system. Hum Pathol 2022; 134:92-101. [PMID: 36566905 DOI: 10.1016/j.humpath.2022.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Penile squamous cell carcinomas (SCC) originating in the shaft are rare. pT1/pT2 categories in the American Joint Committee on Cancer (AJCC) staging manual (8th edition) are poorly defined for SCCs arising in the dorsal shaft as anatomic structures differ between the glans and dorsal shaft (corpus spongiosum vs dartos/Buck's fascia, respectively). We reviewed six penile SCC cases exclusive to the shaft, an unusual presentation, identified amongst 120 patients treated with penectomy. We propose a novel pT staging system for dorsal shaft tumors tailored to its anatomic landmarks, where tumors extending to Buck's fascia are considered pT2 instead of pT1. The mean age at penectomy, average duration of follow-up, and mean depth of invasion were 64 years, 45 months, and 9.8 mm, respectively. Four cases were moderately differentiated, HPV-negative SCCs of the usual type and two cases were HPV-positive basaloid and warty-basaloid carcinomas. Three cases had nodal or distant metastasis at the time of penectomy, and histologic assessment in these cases showed invasion into the Buck's fascia or deeper. According to the current AJCC system, only one of these three cases would be staged as ≥ pT2. In contrast, all three metastatic tumors would be staged as ≥ pT2 in the proposed model. At last follow-up, one patient died of disease-related complications. Based on this limited series, the proposed staging model appears to suggest better patient stratification for pT1/pT2 stages. This model incorporates Buck's fascia, which has been postulated as a pathway of tumor infiltration. Additional studies are needed to validate this model.
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Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Ruifeng Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
| | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Sofia Canete-Portillo
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35233, USA.
| | - Diego F Sanchez
- Instituto de Patología e Investigación, Asunción, 1228, Paraguay.
| | | | - Surendra Dasari
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, 400012, India.
| | | | - Rafael E Jimenez
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
| | - Lori A Erickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
| | | | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA.
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