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Ge S, Zheng L, Li Y, Gan L, Wang Z, Zeng Z, Meng C, Li K, Ma J, Wang D, Ren Y. Comparing the safety and effectiveness of minimally invasive surgery and open inguinal lymph node dissection in penile cancer: A systematic review and meta-analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108553. [PMID: 39059191 DOI: 10.1016/j.ejso.2024.108553] [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: 01/07/2024] [Revised: 06/04/2024] [Accepted: 07/18/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVE To compare the safety and effectiveness of minimally invasive surgery (MIS) with open inguinal lymph node dissection (O-ILND) in penile cancer. METHODS We performed a systematic reviews and cumulative meta-analyses of primary results of interest according to PRISMA criteria, and quality assessment followed AMSTAR. The system searched five databases, including Zhiwang, Embase, PubMed, Cochrane Library and Web of Science. The search period ranged was from database creation until September 2023. The statistical analysis software used Stata16. RESULTS A total of 16 studies, including 898 patients. Compared to O-ILND, MIS is superior in length of stay (WMD = -2.96, 95%CI [-4.38, -1.54], P < 0.05), drainage time (WMD = -3.24, 95%CI [-4.70, -1.78], P < 0.05) and estimated blood loss (WMD = -35.70, 95%CI [-46.27, -25.14], P < 0.05), while operation time, recurrence rate and 5-year overall survival rate are the same. The number of lymph nodes dissection between the two groups are not statistically significant. Subgroup analyses found that there are more lymph nodes dissection in robotic-assisted inguinal lymph nodes dissection (WMD = 0.50, 95%CI [0.20, 0.80], P < 0.05). The overall complication rate of MIS was lower (OR = 0.26, 95%CI [0.09, 0.70], P < 0.05). CONCLUSION Minimally invasive inguinal lymph nodes dissection appears to be a better option for penile cancer cases. But more large samples and multicenter studies are needed to further confirm.
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Affiliation(s)
- Si Ge
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China; Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Lei Zheng
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Yunxiang Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China; Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China.
| | - Lijian Gan
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Zuoping Wang
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Zhiqiang Zeng
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Chunyang Meng
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Kangsen Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Jiakai Ma
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Deyu Wang
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, China
| | - Yuan Ren
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, China
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Sarcan S, Wolff I, Lusuardi L, Kravchuk A, Wiegland J, Yakac A, Thomas C, Burger M, Gilfrich C, Lebentrau S, Ahyai S, Merseburger A, May M. The landscape of penile cancer research in Germany and Austria: a survey among professors in academic centers holding chair positions and results of a literature search. World J Urol 2024; 42:12. [PMID: 38189947 DOI: 10.1007/s00345-023-04719-y] [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: 06/19/2023] [Accepted: 11/03/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Research on penile cancer (PeCa) is predominantly conducted in countries with centralized treatment of PeCa-patients. In Germany and Austria (G + A), no state-regulated centralization is established, and no information is available on how PeCa-research is organized. METHODS Current research competence in PeCa was assessed by a 36-item questionnaire sent to all chairholders of urological academic centers in G + A. Based on PubMed records, all scientific PeCa-articles of 2012-2022 from G + A were identified. Current research trends were assessed by dividing the literature search into two periods (P1: 2012-2017, P2: 2018-2022). A bibliometric analysis was supplemented. RESULTS Response rate of the questionnaire was 75%, a median of 13 (IQR: 9-26) PeCa-patients/center was observed in 2021. Retrospective case series were conducted by 38.9% of participating clinics, while involvement in randomized-controlled trials was stated in 8.3% and in basic/fundamental research in 19.4%. 77.8% declared an interest in future multicenter projects. 205 PeCa-articles were identified [median impact factor: 2.77 (IQR: 0.90-4.37)]. Compared to P1, P2 showed a significant increase in the median annual publication count (29 (IQR: 13-17) vs. 15 (IQR: 19-29), p < 0.001), in multicenter studies (79.1% vs. 63.6%, p = 0.018), and in multinational studies (53% vs. 28.9%, p < 0.001); the proportion of basic/fundamental research articles significantly declined (16.5% vs. 28.9%, p = 0.041). Four of the top-5 institutions publishing PeCa-articles are academic centers. Bibliometric analyses revealed author networks, primary research areas in PeCa, and dominant journals for publications. CONCLUSIONS Given the lack of centralization in G + A, this analysis highlights the need for research coordination within multicenter PeCa-projects. The decline in basic/fundamental research should be effectively addressed by the allocation of funded research projects.
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Affiliation(s)
- Semih Sarcan
- Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Ingmar Wolff
- Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - Lukas Lusuardi
- Department of Urology and Andrology, Paracelsus Medical University, Salzburg, Austria
| | - Anton Kravchuk
- Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Jens Wiegland
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Abdulbaki Yakac
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Christian Thomas
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Maximilian Burger
- Department of Urology, University of Regensburg, Caritas St. Josef Medical Center, Regensburg, Germany
| | - Christian Gilfrich
- Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Steffen Lebentrau
- Department of Urology, Otto-Von-Guericke-University Magdeburg, Magdeburg, Germany
- Department of Urology, Werner Forssmann Hospital, Eberswalde, Germany
| | - Sascha Ahyai
- Department of Urology, Medical University of Graz, Graz, Austria
| | - Axel Merseburger
- Department of Urology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Matthias May
- Department of Urology, St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany.
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Yakac A, Lebentrau S, Lusuardi L, Sarcan S, Burger M, Merseburger AS, Wiegland J, Gilfrich C, Wolff I, Ahyai S, May M, Thomas C. Centralizing Penile Cancer Care in Germany and Austria: Just a Dream or a Fast-Approaching Reality? Results of a Survey Study among Urological Department Chairs and Modeling of Real Treatment Numbers of Penile Cancer Patients. Urol Int 2023; 107:916-923. [PMID: 37918360 DOI: 10.1159/000534089] [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] [Accepted: 09/02/2023] [Indexed: 11/04/2023]
Abstract
INTRODUCTION In countries characterized by a centralization of therapy management, patients with penile cancer (PeCa) have shown improvements in guideline adherence and ultimately, improved carcinoma-specific survival. Germany and Austria (G + A) have no state-regulated centralization of PeCa management, and the perspectives of urological university department chairs (UUDCs) in these countries, who act as drivers of professional and political developments, on this topic are currently unknown. METHODS Surveys containing 36 response options, including specific questions regarding perspectives on PeCa centralization, were sent to the 48 UUDC in G + A in January 2023. In addition to analyzing the responses, closely following the CROSS checklist, a modeling of the real healthcare situation of in-house PeCa patients in G + A was conducted. RESULTS The response rate was 75% (36/48). 94% and 89% of the UUDCs considered PeCa centralization meaningful and feasible in the medium term, respectively. Among the UUDCs, 72% estimated centralization within university hospitals as appropriate, while 28% favored a geographically oriented approach. Additionally, 97% of the UUDCs emphasized the importance of bridging the gap until implementation of centralization by establishing PeCa second-opinion portals. No country-specific differences were observed. The median number of in-house PeCa cases at the university hospitals in G + A was 13 (interquartile range: 9-26). A significant positive correlation was observed between the annual number of in-house PeCa cases at a given university hospital and the perspective of the UUDCs that centralization as meaningful by its UUDC (0.024). Under assumptions permissible for modeling, the average number of in-house PeCa cases in academic hospitals in G + A was approximately 30 times higher than in nonacademic hospitals. CONCLUSION This study provides the first data on the perspectives of UUDCs in G + A concerning centralization of PeCa therapy management. Even without state-regulated centralization in G + A, there is currently a clear focusing of PeCa treatments in university hospitals. Further necessary steps toward a structured PeCa centralization are discussed in this manuscript.
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Affiliation(s)
- Abdulbaki Yakac
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Steffen Lebentrau
- Department of Urology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Department of Urology, Werner Forssmann Hospital, Eberswalde, Germany
| | - Lukas Lusuardi
- Department of Urology and Andrology, Paracelsus Medical University, Salzburg, Austria
| | - Semih Sarcan
- Department of Urology, University Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Maximilian Burger
- Department of Urology, Caritas St. Josef Medical Center, University of Regensburg, Regensburg, Germany
| | - Axel S Merseburger
- Department of Urology, University Lübeck, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - Jens Wiegland
- St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Christian Gilfrich
- St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Ingmar Wolff
- Department of Urology, University Medicine Greifswald, Greifswald, Germany
| | - Sascha Ahyai
- Department of Urology, University of Graz, Graz, Austria
| | - Matthias May
- St. Elisabeth Hospital Straubing, Brothers of Mercy Hospital, Straubing, Germany
| | - Christian Thomas
- Department of Urology, Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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Scornajenghi CM, Asero V, Bologna E, Basile G, De Angelis M, Moschini M, Del Giudice F. Organ-sparing treatment for T1 and T2 penile cancer: an updated literature review. Curr Opin Urol 2023; Publish Ahead of Print:00042307-990000000-00098. [PMID: 37377374 DOI: 10.1097/mou.0000000000001109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
PURPOSE OF REVIEW Penile cancer (PeCa) is an orphan disease due to its rare incidence in high-income countries. Traditional surgical options for clinical T1-2 disease, including partial and total penectomy, can dramatically affect patient's quality of life and mental health status. In selected patients, organ-sparing surgery (OSS) has the potential to remove the primary tumor with comparable oncologic outcomes while maintaining penile length, sexual and urinary function. In this review, we aim to discuss the indications, advantages, and outcomes of various OSSs currently available for men diagnosed with PeCa seeking an organ-preserving option. RECENT FINDINGS Patient survival largely depends on spotting and treating lymph node metastasis at an early stage. The required surgical and radiotherapy skill sets cannot be expected to be available in all centers. Consequently, patients should be referred to high-volume centers to receive the best available treatments for PeCa. SUMMARY OSS should be used for small and localized PeCa (T1-T2) as an alternative to partial penectomy to preserve patient's quality of life while maintaining sexual and urinary function and penile aesthetics. Overall, there are different techniques that can be used with different response and recurrence rates. In case of tumor recurrence, partial penectomy or radical penectomy is feasible, without impacting overall survival.
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Affiliation(s)
- Carlo Maria Scornajenghi
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Vincenzo Asero
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Eugenio Bologna
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
| | - Giuseppe Basile
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Mario De Angelis
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Marco Moschini
- Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute
- Division of Oncology, Unit of Urology, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Francesco Del Giudice
- Department of Maternal Infant and Urologic Sciences, 'Sapienza' University of Rome, Policlinico Umberto I Hospital, Rome
- Department of Urology, Stanford University School of Medicine, Stanford, California, USA
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Lebentrau S, Yakac A, Lusuardi L, Thomas C, Sarcan S, Burger M, Merseburger AS, Wiegland J, Gilfrich C, Wolff I, May M. [Are there any volume-related effects on treatment options for patients with penile cancer? Results of a survey among university hospitals in Germany and Austria]. Aktuelle Urol 2023. [PMID: 37339667 DOI: 10.1055/a-2090-5199] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Currently, 959 men in Germany and 67 in Austria are diagnosed with penile cancer each year, with an increase of approximately 20% in the last decade [RKI 2021, Statcube.at 2023]. Despite the rising incidence, the number of cases per hospital remains low. The median annual number of penile cancer cases at university hospitals in the DACH region was 7 patients (IQR 5-10) in 2017 [E-PROPS group 2021]. The compromised institutional expertise due to low case numbers is compounded with inadequate adherence to penile cancer guidelines, as shown in several studies. The centralization, which is rigorously implemented in countries such as the UK, enabled a significant increase in organ-preserving primary tumor surgery and stage-adapted lymphadenectomies, as well as improved patient survival in cases of penile cancer, resulting in a claim for a similar centralization in Germany and Austria. The aim of this study was to determine the current effects of case volume on penile cancer related treatment options at university hospitals in Germany and Austria. MATERIALS AND METHODS In January 2023, a survey was sent to the heads of 48 urological university hospitals in Germany and Austria, including questions regarding case volume in 2021 (total number of inpatient and penile cancer cases), treatment options for primary tumors and inguinal lymphadenectomy (ILAE), the availability of a designated penile cancer surgeon, and the professional responsibility for systemic therapies in penile cancer. Correlations and differences related to case volume were statistically analyzed without adjustments. RESULTS The response rate was 75% (n=36/48). In total, 626 penile cancer patients were treated at the 36 responding university hospitals in 2021, representing approximately 60% of the expected incidence in Germany and Austria. The annual median total number of cases was 2807 (IQR 1937-3653), and for penile cancer, it was 13 (IQR 9-26). There was no significant correlation between the total inpatient and penile cancer caseloads (p=0.34). The number of organ-preserving therapy procedures for the primary tumor, the availability of modern ILAE procedures, the presence of a designated penile cancer surgeon, and the responsibility for systemic therapies were not significantly influenced by the total inpatient or penile cancer case volume of the treating hospitals, regardless of whether the case volumes were dichotomized at the median or upper quartile. No significant differences between Germany and Austria were observed. CONCLUSION Despite a significant increase in the annual number of penile cancer cases at university hospitals in Germany and Austria compared to 2017, we found no case volume-related effects on structural quality with respect to penile cancer therapy. In the light of the proven benefits of centralization, we interpret this result as an argument for the necessity of establishing nationally organized penile cancer centers with even higher case volumes compared to the status quo, in light of the proven benefits of centralization.
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Affiliation(s)
- Steffen Lebentrau
- Klinik für Urologie, Uroonkologie, robotergestützte und fokale Therapie, Universitätsklinikum Magdeburg, Magdeburg, Germany
- Urologische Klinik, GLG Werner Forssmann Klinikum Eberswalde, Eberswalde, Germany
| | - Abdulbaki Yakac
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Lukas Lusuardi
- Urology, Paracelsus Medizinische Privatuniversitat, Salzburg, Austria
- Universitätsklinik für Urologie und Andrologie, Uniklinikum Salzburg, Salzburg, Austria
| | - Christian Thomas
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Semih Sarcan
- Klinik für Urologie, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lubeck, Germany
| | - Maximilian Burger
- Klinik für Urologie, Universität Regensburg Fakultät für Medizin, Regensburg, Germany
| | - Axel S Merseburger
- Urology, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Jens Wiegland
- Klinik und Poliklinik für Urologie, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Christain Gilfrich
- Urologische Klinik, St. Elisabeth-Klinikums Straubing, Straubing, Germany
| | - Ingmar Wolff
- Klinik und Poliklinik für Urologie, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Matthias May
- Klinik für Urologie, St. Elisabeth Klinikum Straubing, Straubing, Germany
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May M, Lebentrau S, Watkin N, Albersen M, Protzel C, Chahoud J, Brouwer OR, Pettaway CA, Pagliaro LC, Necchi A, Hakenberg OW, Ayres B, Spiess PE. [Initial presentation of the Pentafecta score as a quality instrument for outcome evaluation of primary surgical treatment in patients with penile cancer]. Aktuelle Urol 2023. [PMID: 37339668 DOI: 10.1055/a-2065-8256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
BACKGROUND Recently, the Tetrafecta score has been published as the first instrument for assessing the quality of primary surgical treatment for penile cancer (PECa). An external scientific discussion about the defining criteria is still pending and forms the study objective. MATERIAL AND METHODS An international working group consisting of 12 urologists and an oncologist with clinical and academic-scientific expertise in penile cancer was established. In a modified four-stage Delphi process, a total of 13 criteria for PECa patients in clinical AJCC stages 1-4 (T1-3N0-3, but M0) were defined, incorporating the Tetrafecta criteria. Each expert had to select five of these criteria in a secret ballot to generate an individual Pentafecta score. Subsequently, the experts' ratings were aggregated and a final Pentafecta score was formed. RESULTS None of the original Tetrafecta criteria were included in the final Pentafecta score, which consisted of the following criteria: 1) organ preservation, if possible (≤T2), but always with negative surgical margins, 2) bilateral inguinal lymph node dissection (ILND) from ≥pT1G2N0, 3) perioperative chemotherapy if indicated by guidelines, 4) ILND, if indicated, within a maximum of three months after primary tumour resection, and 5) the treating clinic should perform at least 15 primary surgical treatments in PECa patients. Only in seven out of the 13 experts (54%), a strong correlation was found between individual Pentafecta scores and the final Pentafecta score (rsp >0.60). CONCLUSION Based on a moderated voting process among international PECa experts, a Pentafecta score was developed as a quality assurance instrument for primary surgical treatment, which now needs to be validated using patient-relevant and patient-reported endpoints.
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Affiliation(s)
- Matthias May
- Klinik für Urologie, St. Elisabeth Klinikum Straubing, Straubing, Germany
| | - Steffen Lebentrau
- Urology, Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany
| | - Nick Watkin
- Department of Urology, St George's University Hospitals NHS, London, London, United Kingdom of Great Britain and Northern Ireland
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, Leuven, Leuven, Belgium
| | - Chris Protzel
- Urologie, HELIOS Kliniken Schwerin, Schwerin, Germany
| | - Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, Tampa, United States
| | - Oscar R Brouwer
- Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Amsterdam, Netherlands
| | - Curtis A Pettaway
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, Houston, Germany
| | - Lance C Pagliaro
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN, Rochester, United States
| | - Andrea Necchi
- Department of Urology, IRCCS San Raffaele Hospital and Scientific Institute, Milan, Milan, Italy
| | | | - Ben Ayres
- Department of Urology, St George's University Hospitals NHS, London, London, United Kingdom of Great Britain and Northern Ireland
| | - Philippe E Spiess
- Department of Urology, H. Lee Moffitt Cancer Center, Tampa, FL, Tampa, United States
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May M, Lebentrau S, Ayres B, Albersen M, Protzel C, Chahoud J, Brouwer OR, Pettaway CA, Pagliaro LC, Necchi A, Watkin N, Hakenberg OW, Spiess PE. The Goal of Achieving High-Quality Surgical First-Line Therapy in Patients with Penile Cancer Is Important; However, Some Collective Efforts Are Still Required in Order to Reach It. Comment on Brassetti et al. Combined Reporting of Surgical Quality and Cancer Control after Surgical Treatment for Penile Tumors with Inguinal Lymph Node Dissection: The Tetrafecta Achievement. Curr. Oncol. 2023, 30, 1882-1892. Curr Oncol 2023; 30:4269-4274. [PMID: 37185438 PMCID: PMC10136864 DOI: 10.3390/curroncol30040325] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 04/03/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
We read with great interest the manuscript by Brassetti et al. recently published in your journal and hope it will encourage discussion and debate around the optimization of the surgical management of patients with penile cancer (PECa) [...].
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Affiliation(s)
- Matthias May
- Department of Urology, St. Elisabeth-Clinic Straubing, Brothers of Mercy Hospital, 94315 Straubing, Germany
| | - Steffen Lebentrau
- Department of Urology, University of Magdeburg, 39106 Magdeburg, Germany
| | - Ben Ayres
- Department of Urology, St George's University Hospitals NHS, London SW17 0QT, UK
| | - Maarten Albersen
- Department of Urology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Chris Protzel
- Department of Urology, Helios Clinics Schwerin, 19055 Schwerin, Germany
| | - Jad Chahoud
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
| | - Oscar R Brouwer
- Department of Urology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, The Netherlands
| | - Curtis A Pettaway
- Department of Urology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Lance C Pagliaro
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN 55902, USA
| | - Andrea Necchi
- Department of Urology, IRCCS San Raffaele Hospital and Scientific Institute, 20132 Milano, Italy
| | - Nick Watkin
- Department of Urology, St George's University Hospitals NHS, London SW17 0QT, UK
| | - Oliver W Hakenberg
- Department of Urology, University Medical Center Rostock, 18051 Rostock, Germany
| | - Philippe E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL 33612, USA
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Pang KH, Alnajjar HM, Muneer A. Advances in penile-sparing surgical approaches. Asian J Urol 2022; 9:359-373. [DOI: 10.1016/j.ajur.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/31/2021] [Accepted: 01/18/2022] [Indexed: 11/25/2022] Open
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Chavarriaga J, Pardo J, Suso-Palau D, Becerra L, Camacho D, Godoy F, Forero J, Cabrera M, López-de-Mesa B, Ramirez A, Varela R. Real World Data of Penile Cancer Treatment at a High-Volume Center in South America: Insights and Survival Trends. Urology 2021; 156:199-204. [PMID: 34310915 DOI: 10.1016/j.urology.2021.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 06/28/2021] [Accepted: 07/14/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To report survival trends and oncological outcomes of penile cancer surgically treated patients, at a high-volume center, treating more than 25 patients each year, in a high incidence country. METHODS Clinical charts of all patients that underwent surgical management for penile cancer were reviewed. The primary end points were cancer specific survival (CSS), progression-free survival, and local recurrence free survival. Kaplan-Meier plots were used for survival analyses. Multivariate analysis was performed using cox proportional hazard age-adjusted models to determine the effect of pN, pT, lymphovascular invasion for CSS. RESULTS A total of 209 patients were identified, with a median follow up of 96 months (IQR 49-133). Organ-sparing surgerywas performed in 72.7%, 56.9% underwent dynamic sentinel lymph node biopsy, 110 patients underwent inguinal lymph node dissection, and 45 (21.5%) pelvic lymph node dissection. A total of 75 (35.8%) of patients relapsed, median time to relapse of 12 months (IQR 6-25). Overall estimates of CSS showed an 8-year CSS of 68.9%. Eight-year CSS was 90.5% for N0, and 32.8% in pN3 (P <.001). The Cox proportional hazard model showed that pN1-3, pT2-4, lymphovascular invasion and positive dynamic sentinel lymph node biopsy were the variables associated with worse 8-year CSS. CONCLUSION To the best of our knowledge, we report one of the largest cohorts on the survival outcomes of penile cancer surgical treatment, in a single institution, over a long period of time, were most patients are referred with high-risk, locally advanced or nodal disease.
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Affiliation(s)
- Julián Chavarriaga
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia; Division of Urology, Clínica Imbanaco, Grupo Quirón Salud. Cali, Colombia; Division of Urology, Pontificia Universidad Javeriana. Bogotá, Colombia.
| | - Julián Pardo
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Daniel Suso-Palau
- Division of Urology, Clínica Imbanaco, Grupo Quirón Salud. Cali, Colombia
| | - Luis Becerra
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Diego Camacho
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Fabián Godoy
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Jorge Forero
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Marino Cabrera
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Byron López-de-Mesa
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Angie Ramirez
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
| | - Rodolfo Varela
- Department of Urologic Oncology, Instituto Nacional de Cancerología. Bogotá, Colombia
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Masterson TA, Tagawa ST. A 25-year perspective on advances in an understanding of the biology, evaluation, treatment and future directions/challenges of penile cancer. Urol Oncol 2021; 39:569-576. [PMID: 34219002 DOI: 10.1016/j.urolonc.2021.05.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 05/14/2021] [Accepted: 05/18/2021] [Indexed: 02/05/2023]
Abstract
Squamous cell carcinoma of the penis (SCCP) is uncommon in some countries (including the U.S.), but is an important malignancy elsewhere. As a rare disease, progress has been slow compared to more common tumor types discussed in this anniversary issue and most often limited to single-center or retrospective datasets. In this section we describe developments leading to the current standard approach with current research questions.
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Affiliation(s)
- Timothy A Masterson
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN
| | - Scott T Tagawa
- Division of Hematology & Medical Oncology, Department of Medicine and Department of Urology, Weill Cornell Medicine, New York, NY.
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