1
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Ngweso S, Nzenza T, McMillan K, Sofield D, Lozinskiy M, Hayne D. Current trends in penile cancer survivorship amongst remote patients and Aboriginal people in Western Australia. ANZ J Surg 2023; 93:534-540. [PMID: 36478516 DOI: 10.1111/ans.18177] [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: 01/26/2021] [Revised: 08/27/2021] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Penile cancer is a rare urological malignancy, accounting for less than 1% of all cancers in males. Given its rarity, few studies exist reporting survival outcomes. The primary objective of this project was to review the mortality of patients diagnosed with penile cancer in Western Australia between 1992 and 2017 and to determine if Aboriginal and Torres Strait Islander people and patients in rural and remote regions experience discrepancies in survival outcomes. METHODS All cases of penile cancer recorded within the Western Australia Cancer Registry between 1992 and 2017 were reviewed. Analysis was performed using chi-squared test of association, binomial logistic regression and survival analysis was conducted using Kaplan Meier and Cox Regression analysis. RESULTS One hundred eighty-six cases of penile cancer were identified; 62 patients (33%) were from regional or remote locations and nine patients (4.8%) were Aboriginal. 13 of the regional or remote patients and 5 of the Aboriginal patients died from penile cancer. Patients who were Aboriginal (HR 6.512, CI 2.123-19.968; P = 0.001) or from regional or remote Western Australia (HR 2.382, CI 1.050-5.401; P = 0.038) were at an increased risk of penile cancer-specific mortality. CONCLUSIONS Aboriginal people with penile cancer and men from regional and remote Western Australia experience worse penile cancer-specific survival outcomes.
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Affiliation(s)
- Simeon Ngweso
- Department of Urology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Australian and New Zealand Urogenital and Prostate Cancer Trials Group
| | - Tatenda Nzenza
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- School of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Kevin McMillan
- Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia
| | - David Sofield
- Department of Urology, Bethesda Hospital, Claremont, Western Australia, Australia
- Department of Urology, St John of God Hospital, Subiaco, Western Australia, Australia
| | | | - Dickon Hayne
- Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
- Department of Urology, Austin Hospital, Heidelberg, Victoria, Australia
- Department of Urology, Fiona Stanley Hospital, Murdoch, Western Australia, Australia
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3
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Azevedo RA, Roxo AC, Alvares SHB, Baptista DP, Favorito LA. Use of flaps in inguinal lymphadenectomy in metastatic penile cancer. Int Braz J Urol 2021; 47:1108-1119. [PMID: 34115457 PMCID: PMC8486440 DOI: 10.1590/s1677-5538.ibju.2021.99.14] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 05/20/2021] [Indexed: 04/04/2024] Open
Abstract
PURPOSE Reviewing surgical procedures using fasciocutaneous and myocutaneous flaps for inguinal reconstruction after lymphadenectomy in metastatic penile cancer. MATERIAL AND METHODS We reviewed the current literature of the Pubmed database according to PRISMA guidelines. The search terms used were "advanced penile cancer", "groin reconstruction", and "inguinal reconstruction", both alone and in combination. The bibliographic references used in the selected articles were also analyzed to include recent articles into our research. RESULTS A total of 54 studies were included in this review. About one third of penile cancers are diagnosed with locally advanced disease, often presenting with large lymph node involvement. Defects in the inguinal region resulting from the treatment of metastatic penile cancer are challenging for the surgeon and cause high patient morbidity, rendering primary closure unfeasible. Several fasciocutaneous and myocutaneous flaps of the abdomen and thigh can be used for the reconstruction of the inguinal region, transferring tissue to the affected area, and enabling tensionless closure. CONCLUSIONS The reconstruction of defects in the inguinal region with the aid of flaps allows for faster postoperative recovery and reduces the risk of complications. Thus, the patient will be able to undergo potential necessary adjuvant treatments sooner.
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Affiliation(s)
- Roberta Alvares Azevedo
- Hospital Mário KröeffDivisão de Cirurgia PlásticaRio de JaneiroRJBrasilDivisão de Cirurgia Plástica, Hospital Mário Kröeff, Rio de Janeiro, RJ, Brasil
- Universidade do Estado do Rio de JaneiroDepartamento de Cirurgia GeralRio de JaneiroRJBrasilDepartamento de Cirurgia Geral, Universidade do Estado do Rio de Janeiro – UERJ, Rio de Janeiro, RJ, Brasil
| | - Ana Claudia Roxo
- Universidade do Estado do Rio de JaneiroDivisão de Cirurgia PlásticaRio de JaneiroRJBrasilDivisão de Cirurgia Plástica, Departamento de Cirurgia Geral, Universidade do Estado do Rio de Janeiro – UERJ, Rio de Janeiro, RJ, Brasil
| | - Silvia Helena Baima Alvares
- Hospital Mário KröeffDivisão de Cirurgia PlásticaRio de JaneiroRJBrasilDivisão de Cirurgia Plástica, Hospital Mário Kröeff, Rio de Janeiro, RJ, Brasil
| | - Daniel Pereira Baptista
- Hospital Mário KröeffDivisão de Cirurgia PlásticaRio de JaneiroRJBrasilDivisão de Cirurgia Plástica, Hospital Mário Kröeff, Rio de Janeiro, RJ, Brasil
| | - Luciano A. Favorito
- Universidade do Estado do Rio de JaneiroUnidade de Pesquisa UrogenitalRio de JaneiroRJBrasilUnidade de Pesquisa Urogenital, Universidade do Estado do Rio de Janeiro – UERJ, Rio de Janeiro, RJ, Brasil
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4
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Finneran C, Johnson Peretz J, Blemur D, Palefsky J, Flowers L. "That's Only for Women": The Importance of Educating HIV-Positive Sexual Minority Men on HPV and High Resolution Anoscopy (HRA). J Int Assoc Provid AIDS Care 2021; 20:23259582211016134. [PMID: 34056930 PMCID: PMC8170352 DOI: 10.1177/23259582211016134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 04/07/2021] [Accepted: 04/15/2021] [Indexed: 01/22/2023] Open
Abstract
Gay, bisexual, and other men who have sex with men (MSM) experience disproportionately high burdens of Human Papilloma Virus (HPV)-associated anal cancers. Recent focus has shifted to anorectal cancer prevention through high-resolution anoscopy (HRA); however, little is known about sexual minority men's perceptions, attitudes, or beliefs regarding HRA. We conducted 4 qualitative Focus Group Discussions (FGDs) (n = 15) with sexual minority men, focusing on their beliefs, attitudes, and perceptions of undergoing HRA. Participants discussed their experiences of HPV/HRA as influenced by both their gender and sexuality, including unawareness of HPV disease as a male health issue, challenges relating to female-oriented HPV/HRA language, conception of HPV/HRA as related to prostate health, and connecting their sexual behavior identification as "bottoms" to their need for HRA. As efforts to improve HRA knowledge, access, and uptake among sexual and gender minority communities increase, special attention should be paid to language and messaging choices around HRA.
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Affiliation(s)
- Catherine Finneran
- Department of Internal Medicine, Washington University School of Medicine
in St. Louis, St. Louis, MO, USA
| | - Jason Johnson Peretz
- Global Health and Clinical Science, University of California San
Francisco, San Francisco, CA, USA
| | - Danielle Blemur
- Department of Gynecology and Obstetrics; Emory University School of
Medicine, Atlanta, GA, USA
| | - Joel Palefsky
- Department of Infectious Disease; University of California San
Francisco, San Francisco, CA, USA
| | - Lisa Flowers
- Department of Gynecology and Obstetrics; Emory University School of
Medicine, Atlanta, GA, USA
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5
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Harman RM, Das SP, Bartlett AP, Rauner G, Donahue LR, Van de Walle GR. Beyond tradition and convention: benefits of non-traditional model organisms in cancer research. Cancer Metastasis Rev 2020; 40:47-69. [PMID: 33111160 DOI: 10.1007/s10555-020-09930-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/01/2020] [Indexed: 02/07/2023]
Abstract
Traditional laboratory model organisms are indispensable for cancer research and have provided insight into numerous mechanisms that contribute to cancer development and progression in humans. However, these models do have some limitations, most notably related to successful drug translation, because traditional model organisms are often short-lived, small-bodied, genetically homogeneous, often immunocompromised, are not exposed to natural environments shared with humans, and usually do not develop cancer spontaneously. We propose that assimilating information from a variety of long-lived, large, genetically diverse, and immunocompetent species that live in natural environments and do develop cancer spontaneously (or do not develop cancer at all) will lead to a more comprehensive understanding of human cancers. These non-traditional model organisms can also serve as sentinels for environmental risk factors that contribute to human cancers. Ultimately, expanding the range of animal models that can be used to study cancer will lead to improved insights into cancer development, progression and metastasis, tumor microenvironment, as well as improved therapies and diagnostics, and will consequently reduce the negative impacts of the wide variety of cancers afflicting humans overall.
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Affiliation(s)
- Rebecca M Harman
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Sanjna P Das
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Arianna P Bartlett
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Gat Rauner
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Leanne R Donahue
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA
| | - Gerlinde R Van de Walle
- Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca, NY, 14853, USA.
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6
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Méjean A, Rouprêt M, Rozet F, Bensalah K, Murez T, Game X, Rebillard X, Mallet R, Faix A, Mongiat-Artus P, Fournier G, Neuzillet Y. [Recommendations CCAFU on the management of cancers of the urogenital system during an epidemic with Coronavirus COVID-19]. Prog Urol 2020; 30:221-231. [PMID: 32224294 PMCID: PMC7146722 DOI: 10.1016/j.purol.2020.03.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/16/2022]
Abstract
Objectif La population française est confrontée à la pandémie de COVID-19 et le système de santé a été réorienté en urgence pour la prise en charge des patients atteints du coronavirus. La prise en charge des cancers de l’appareil urinaire et génital masculin doit être adaptée à ce contexte. Matériel et méthode Un avis d’experts documenté par une revue de la littérature a été formulé par le Comité de Cancérologie de l’Association Française d’Urologie (CCAFU). Résultats La prise en charge médicale et chirurgicale des patients atteints de cancers de l’appareil urinaire et génital masculin doit être adaptée en modifiant les modalités de consultation, en priorisant les interventions en fonction du pronostic intrinsèque des cancers en tenant compte des comorbidités du patient. La protection des urologues vis-à-vis du COVID-19 doit être prise en considération. Conclusion Le CCAFU émet un avis d’experts quant aux mesures à prendre pour adapter la prise en charge des cancers de l’appareil urinaire et génital masculin au contexte de pandémie par COVID-19.
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Affiliation(s)
- A Méjean
- Comité de cancérologie de l'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - M Rouprêt
- Comité de cancérologie de l'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - F Rozet
- Comité de cancérologie de l'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - K Bensalah
- Comité de cancérologie de l'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - T Murez
- Comité de cancérologie de l'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - X Game
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - X Rebillard
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - R Mallet
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - A Faix
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - P Mongiat-Artus
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - G Fournier
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France
| | - Y Neuzillet
- Bureau du Conseil d'administration d'Association française d'urologie, 11, rue Viète, 75017 Paris, France.
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7
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Shkolyar E, Laurie MA, Mach KE, Trivedi DR, Zlatev DV, Chang TC, Metzner TJ, Leppert JT, Kao CS, Liao JC. Optical biopsy of penile cancer with in vivo confocal laser endomicroscopy. Urol Oncol 2019; 37:809.e1-809.e8. [DOI: 10.1016/j.urolonc.2019.08.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 07/19/2019] [Accepted: 08/20/2019] [Indexed: 12/16/2022]
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8
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Abstract
Penile cancer is a rare condition and can be very complex to manage. Advances in surgical techniques, imaging, pathological classification and patient pathways have led to improved patient care. The diagnosis of pre-malignant change, penile cancer and metastatic disease along with advances in their treatment are detailed in this review which aims to update clinicians from multiple specialties and countries on penile cancer.
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Affiliation(s)
- Maximilian J Johnston
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
- Department of Surgery & Cancer, Imperial College London, London, UK
| | - Raj Nigam
- Department of Urology, Royal Surrey County Hospital, Guildford, UK
- Institute of Urology, University College London Hospitals, London, UK
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9
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Wei Z, Yu Z, Li H, Peng W, Zhang J, Zhang Y, Song W, Liu J, Yang W, Wang T. The appropriate number of negative lymph nodes dissection for nonmetastatic penile cancer. Andrologia 2018; 51:e13154. [PMID: 30255596 DOI: 10.1111/and.13154] [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: 05/29/2018] [Revised: 08/01/2018] [Accepted: 08/21/2018] [Indexed: 11/28/2022] Open
Abstract
Negative lymph nodes status has been attached more attention as a prognostic indicator for nonmetastatic penile cancer. We aimed to identify the appropriate number of negative lymph nodes dissection for nonmetastatic penile cancer using the Surveillance, Epidemiology and End Results database. A total of 1,470 nonmetastatic patients with penile squamous cell carcinoma were identified during 2004 and 2013. All patients were categorised according to different risk levels and lymphadenectomy. Univariate and multivariate Cox regression analyses were performed to evaluate the relationship between prognostic risk factors and cancer-specific survival. The optimal cut-off value of negative lymph nodes dissection was determined using the X-Tile program. A total of 1,470 patients were categorised into low- (pT1G1), intermediate- (pT1G2) or high-risk (pT1G3 and all higher stages) groups. In multivariate Cox analysis, lymphadenectomy improved the cancer-specific survival for patients in high-risk group (p = 0.014). Further, the optimal cut-off value of negative lymph nodes dissection for high-risk patients was 5 and patients with >5 negative lymph nodes had a higher cancer-specific survival (χ2 = 9.3676, p < 0.05). Therefore, lymphadenectomy improved survival for high-risk penile cancer and the removal of more than five negative lymph nodes was correlated with higher cancer-specific survival for high-risk patients who underwent lymphadenectomy.
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Affiliation(s)
- Zhewen Wei
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhe Yu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hao Li
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Peng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junfeng Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zhang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wen Song
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jihong Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weimin Yang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Suárez-Bonnet A, Willis C, Pittaway R, Smith K, Mair T, Priestnall SL. Molecular carcinogenesis in equine penile cancer: A potential animal model for human penile cancer. Urol Oncol 2018; 36:532.e9-532.e18. [PMID: 30270026 DOI: 10.1016/j.urolonc.2018.09.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 08/19/2018] [Accepted: 09/03/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate the expression of COX-2, E-cadherin, vimentin, 14-3-3σ, and Phosphatase and tensin homolog (PTEN) tumor-related proteins in equine penile papillomas (ePP) and squamous cell carcinomas (ePSCC), the occurrence of epithelial-mesenchymal transition (EMT) at the invasion front (IF) and compare our findings with current knowledge on human penile squamous cell carcinoma (hPSCC). MATERIAL AND METHODS We analyzed, by immunohistochemistry in 45 equine penile proliferative epithelial lesions, the expression of COX-2, E-cadherin, vimentin, 14-3-3σ, and PTEN using monoclonal antibodies. Tumors were histopathologically classified as well-differentiated or poorly differentiated using the IF grading scheme. Semiquantitative analysis was performed to determine down or up-regulation of the proteins and association with histopathological characteristics were statistically investigated using Mann-Whitney U test and/or Spearman's tests. RESULTS COX-2 was neo-expressed in 86.6% of the cases and expression progressively increased from ePP to ePSCC (P = 0.0003) and from well to poorly differentiated (P = 0.033). High COX-2 expression was associated with a high mitotic index (MI) (P = 0.026). In contrast to normal epidermis, ePSCC had very low E-cadherin expression in 64% of the cases (P = 0.0005). Vimentin was neo-expressed in 65% of poorly differentiated ePSCC at the IF indicating EMT. Cytoplasmic 14-3-3σ protein expression was reduced in 42% of the ePSCC and additionally, nuclear expression of 14-3-3σ in neoplastic keratinocytes and in the cytoplasm of stromal fibroblasts at the IF was features only found in ePSCC. PTEN protein showed a tendency to be decreased or lost in ePSCC. CONCLUSIONS Our study provides evidence of molecular abnormalities in ePSCC similar to those reported for human PSCC. The occurrence of EMT at the IF is a common event in ePSCC. Naturally occurring ePSCC could serve as a valuable preclinical animal model to explore upcoming therapeutic options for hPSCC.
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Affiliation(s)
- Alejandro Suárez-Bonnet
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK.
| | - Claire Willis
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - Rachel Pittaway
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - Ken Smith
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
| | - Tim Mair
- Bell Equine Veterinary Clinic, Mereworth, Maidstone, Kent ME18 5GS, UK
| | - Simon L Priestnall
- Department of Pathobiology and Population Sciences, The Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
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11
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Sosnowski R, Wolski JK, Kulpa M, Ziętalewicz U, Kosowicz M, Kalinowski T, Demkow T. Assessment of quality of life in patients surgically treated for penile cancer: Impact of aggressiveness in surgery. Eur J Oncol Nurs 2017; 31:1-5. [DOI: 10.1016/j.ejon.2017.08.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/23/2017] [Accepted: 08/25/2017] [Indexed: 11/30/2022]
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12
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Mikada M, Sukhbaatar A, Miura Y, Horie S, Sakamoto M, Mori S, Kodama T. Evaluation of the enhanced permeability and retention effect in the early stages of lymph node metastasis. Cancer Sci 2017; 108:846-852. [PMID: 28211204 PMCID: PMC5448659 DOI: 10.1111/cas.13206] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 02/12/2017] [Accepted: 02/14/2017] [Indexed: 02/02/2023] Open
Abstract
Most solid cancers spread to new sites via the lymphatics before hematogenous dissemination. However, only a small fraction of an intravenously administered anti‐cancer drug enters the lymphatic system to reach metastatic lymph nodes (LN). Here, we show that the enhanced permeability and retention (EPR) effect is not induced during the early stages of LN metastasis. Luciferase‐expressing tumor cells were injected into the subiliac LN of the MXH10/Mo‐lpr/lpr mouse to induce metastasis to the proper axillary LN (PALN). In vivo biofluorescence imaging was used to confirm metastasis induction and to quantify the EPR effect, measured as PALN accumulation of intravenously injected indocyanine green (ICG) liposomes. PALN blood vessel volume changes were measured by contrast‐enhanced high‐frequency ultrasound imaging. The volume and density of blood vessels in the PALN increased until day 29 after inoculation, whereas the LN volume remained constant. ICG retention was first detected on day 29 post‐inoculation. While CD31‐positive cells increased up to day 29 post‐inoculation, α‐smooth muscle actin‐positive cells were detected on day 29 post‐inoculation for the first time. These results suggest that the EPR effect was not induced in the early stages of LN metastasis; therefore, systemic chemotherapy would likely not be beneficial during the early stages of LN metastasis. The development of an alternative drug delivery system, independent of the EPR effect, is required for the treatment of LN metastasis.
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Affiliation(s)
- Mamoru Mikada
- Laboratory of Biomedical Engineering for Cancer, Tohoku University, Aoba, Sendai, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, Aoba, Sendai, Japan
| | - Ariunbuyan Sukhbaatar
- Laboratory of Biomedical Engineering for Cancer, Tohoku University, Aoba, Sendai, Japan.,Graduate School of Dentistry, Tohoku University, Aoba, Sendai, Japan
| | - Yoshinobu Miura
- Laboratory of Biomedical Engineering for Cancer, Tohoku University, Aoba, Sendai, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, Aoba, Sendai, Japan
| | - Sachiko Horie
- Laboratory of Biomedical Engineering for Cancer, Tohoku University, Aoba, Sendai, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, Aoba, Sendai, Japan
| | - Maya Sakamoto
- Department of Oral Diagnosis, Tohoku University Hospital, Aoba, Sendai, Japan
| | - Shiro Mori
- Laboratory of Biomedical Engineering for Cancer, Tohoku University, Aoba, Sendai, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, Aoba, Sendai, Japan.,Department of Oral and Maxillofacial Surgery, Tohoku University Hospital, Aoba, Sendai, Japan
| | - Tetsuya Kodama
- Laboratory of Biomedical Engineering for Cancer, Tohoku University, Aoba, Sendai, Japan.,Biomedical Engineering Cancer Research Center, Graduate School of Biomedical Engineering, Tohoku University, Aoba, Sendai, Japan
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13
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Leone A, Diorio GJ, Pettaway C, Master V, Spiess PE. Contemporary management of patients with penile cancer and lymph node metastasis. Nat Rev Urol 2017; 14:335-347. [PMID: 28401957 DOI: 10.1038/nrurol.2017.47] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Penile cancer is a rare disease that causes considerable physical and psychological patient morbidity, especially at advanced stages. Patients with low-stage nodal metastasis can achieve durable survival with surgery alone, but those with extensive locoregional metastasis have overall low survival. Contemporary management strategies for lymph node involvement in penile cancer aim to minimize the morbidity associated with traditional radical inguinal lymphadenectomy through appropriate risk stratification while optimizing oncological outcomes. Modified (or superficial) inguinal lymph node dissection and dynamic sentinel lymph node biopsy are diagnostic modalities that have been recommended in patients with high-risk primary penile tumours and nonpalpable inguinal lymph nodes. In addition, advances in minimally invasive and robot-assisted lymphadenectomy techniques are being investigated in patients with penile cancer and might further decrease lymphadenectomy-related adverse effects. The management of patients with advanced disease has evolved to include multimodal treatment with systemic chemotherapy before surgical intervention and can include adjuvant chemotherapy after pelvic lymphadenectomy. The role of radiotherapy in the neoadjuvant or adjuvant setting remains largely unclear, owing to a lack of high-level evidence of possible benefits. New targeted therapies have shown efficacy in squamous cell carcinomas of other sites and might also prove effective in patients with penile cancer.
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Affiliation(s)
- Andrew Leone
- H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida 33602, USA
| | - Gregory J Diorio
- H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida 33602, USA
| | - Curtis Pettaway
- The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit Number: 1373, Houston, Texas 77030, USA
| | - Viraj Master
- Emory University School of Medicine, 1365 Clifton Road NE, Building B, Room 1485, Atlanta, Georgia 30030, USA
| | - Philippe E Spiess
- H. Lee Moffitt Cancer Center, 12902 USF Magnolia Drive, Tampa, Florida 33602, USA
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Yoo HS, Satti S, Matrana M. Primary Undifferentiated Pleomorphic Sarcoma of the Penis. Ochsner J 2017; 17:434-437. [PMID: 29230132 PMCID: PMC5718460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Primary penile sarcoma is a rare disease that affects men of all ages. Different subtypes of primary penile sarcoma exist, with the rarest being pleomorphic sarcoma. Delays in presentation and diagnosis of primary penile sarcoma have been reported because of its benign-appearing presenting features and rarity. If penile sarcoma is left untreated, the clinical consequence is metastasis that is fatal in most cases. CASE REPORT We report an extremely rare case of undifferentiated pleomorphic sarcoma of the penis in a 59-year-old patient who initially presented with a slow-growing penile nodule. The tumor was surgically excised, but the patient experienced local recurrence and, despite receiving chemotherapy and surgery, died of metastatic disease 15 months after initial presentation. CONCLUSION Vigilance regarding biopsy and intervention for penile nodules may lead to early diagnosis and improved clinical outcomes.
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Affiliation(s)
- Hyung Sun Yoo
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
| | - Suma Satti
- Department of Hematology and Oncology, Ochsner Clinic Foundation, New Orleans, LA
| | - Marc Matrana
- The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA
- Department of Hematology and Oncology, Ochsner Clinic Foundation, New Orleans, LA
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