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O'Connell KA, Thomas JL, Murad F, Zhou G, Sonpavde GP, Mossanen M, Clinton TN, Ji-Xu A, Spiess PE, Rossi AM, Schmults CD. Factors predictive of recurrence, metastasis and death in node-negative penile squamous cell carcinoma: A retrospective multicentre cohort study. J Eur Acad Dermatol Venereol 2024. [PMID: 38842227 DOI: 10.1111/jdv.20093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/29/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Penile squamous cell carcinoma (PSCC) carries significant morbidity and mortality. Literature is limited regarding prognostic factors, especially prognostic factors for development of metastasis. OBJECTIVES To identify independent prognostic factors associated with poor outcomes, defined as local recurrence (LR), metastasis and disease-specific death (DSD) in clinically node-negative PSCC undergoing local therapy. METHODS Thirty-two-year Retrospective Multicenter Cohort Study of 265 patients with histologically diagnosed PSCC at three tertiary care centres. Predictive models based on patient or tumour characteristics were developed. RESULTS Local recurrence occurred in 56 patients, metastasis in 52 patients and DSD in 40 patients. In multivariable models, the following five factors were independent prognostic factors based on subhazard ratio (SHR): history of balanitis (LR SHR: 2.3; 95% CI 1.2-4.2), poor differentiation (metastasis SHR 1.9; 95% CI 1.0-3.6), invasion into the corpora (metastasis SHR: 3.0; 95% CI 1.5-5.8 and DSD SHR: 4.5; 95% CI 1.7-12.1), perineural invasion (PNI) (metastasis SHR: 2.8; 95% CI 1.4-5.5 and DSD SHR: 3.5; 95% CI, 1.6-7.8) and a history of phimosis (DSD SHR: 2.5; 95% CI 1.2-5.3). The 5-year cumulative incidence of metastasis was higher for tumours with PNI [cumulative incidence function (CIF) = 55%, 95% CI 38-75 vs. CIF 15%, 95% CI 11-22], corporal invasion (CIF: 35%, 95% CI 26-47 vs. 12%, 95% CI 7-19) and poorly differentiated tumours (CIF = 46%, 95% CI 31-64 vs. CIF 15%, 95% CI 11-22). CONCLUSIONS History of balanitis, history of phimosis, PNI, corporal invasion and poor differentiation are independent risk factors associated with poor outcomes. Since poor differentiation and PNI currently constitute only T1b disease, prognostic staging can likely be improved.
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Affiliation(s)
- Katie A O'Connell
- Brigham & Women's/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
- Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jacob L Thomas
- Division of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
- Weill Cornell Medical College, New York City, New York, USA
| | - Fadi Murad
- Brigham & Women's/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Guohai Zhou
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | | | - Matthew Mossanen
- Division of Urology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Timothy N Clinton
- Division of Urology, Brigham and Women's Hospital and Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Antonio Ji-Xu
- Department of Dermatology, University of California, Davis, School of Medicine, Sacramento, California, USA
| | | | - Anthony M Rossi
- Division of Dermatology, Memorial Sloan Kettering Cancer Center, New York City, New York, USA
- Weill Cornell Medical College, New York City, New York, USA
| | - Chrysalyne D Schmults
- Brigham & Women's/Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
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Tekin B, Sali AP, Menon S, Cheville JC, Smith CY, Jenkins SM, Dasari S, Enninga EAL, Norgan AP, Cubilla AL, Whaley RD, Hernandez LH, Jimenez RE, Garcia JJ, Thompson RH, Leibovich BC, Karnes RJ, Boorjian SA, Pagliaro LC, Erickson LA, Guo R, Gupta S. Comparison of a modified staging system with 8th edition AJCC criteria in a North American cohort of pT2/pT3 HPV-negative penile squamous cell carcinoma. Hum Pathol 2024; 148:81-86. [PMID: 38782101 DOI: 10.1016/j.humpath.2024.05.008] [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: 04/15/2024] [Revised: 05/20/2024] [Accepted: 05/20/2024] [Indexed: 05/25/2024]
Abstract
The staging for pT2/pT3 penile squamous cell carcinoma (pSCC) has undergone major changes. Some authors proposed criteria wherein the distinction between pT2/pT3 was made using the same histopathological variables that are currently utilized to differentiate pT1a/pT1b. In this single-institution, North American study, we focused on (HPV-negative) pT2/3 pSCCs (i.e., tumors invading corpus spongiosum/corpus cavernosum), and compared the prognostic ability of the following systems: (i) AJCC (8th edition) criteria; (ii) modified staging criteria proposed by Sali et al. (Am J Surg Pathol. 2020; 44:1112-7). In the proposed system, pT2 tumors were defined as those devoid of lymphovascular invasion (LVI) or perineural invasion (PNI), and were not poorly differentiated; whereas pT3 showed one or more of the following: LVI, PNI, and/or grade 3. 48 pT2/pT3 cases were included (AJCC, pT2: 27 and pT3: 21; Proposed, pT2: 22 and pT3: 26). The disease-free survival (DFS) and progression-free survival (PFS) did not differ between pT2 and pT3, following the current AJCC definitions (p = 0.19 and p = 0.10, respectively). When the pT2/3 stages were reconstructed using the modified criteria, however, a statistically significant difference was present in both DFS and PFS between pT2 and pT3 (p = 0.004 and p = 0.003, respectively). The proposed staging system has the potential to improve the prognostication of pT2/pT3 tumors in pSCC. Each of these histopathologic variables has been shown to have a significant association with outcomes in pSCC, which is an advantage. Further studies are needed to demonstrate the utility of this modified staging system in patient populations from other geographic regions.
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Affiliation(s)
- Burak Tekin
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Akash P Sali
- Department of Pathology, Karkinos Healthcare Private Limited, Navi Mumbai, Maharashtra, India.
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India.
| | - John C Cheville
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Carin Y Smith
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
| | - Sarah M Jenkins
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA.
| | - Surendra Dasari
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
| | - Elizabeth Ann L Enninga
- Departments of Immunology, Obstetrics and Gynecology, Mayo Clinic College of Medicine, Rochester, MN, USA.
| | - Andrew P Norgan
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Antonio L Cubilla
- Instituto de Patología e Investigación, Universidad Nacional de Asunción, Asunción, Paraguay.
| | - Rumeal D Whaley
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | | | - Rafael E Jimenez
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Joaquin J Garcia
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | | | | | | | | | - Lance C Pagliaro
- Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN, USA.
| | - Lori A Erickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Ruifeng Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
| | - Sounak Gupta
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
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Switlyk MD, Hopland A, Reitan E, Sivanesan S, Brennhovd B, Axcrona U, Hole KH. Multiparametric Magnetic Resonance Imaging of Penile Cancer: A Pictorial Review. Cancers (Basel) 2023; 15:5324. [PMID: 38001583 PMCID: PMC10670261 DOI: 10.3390/cancers15225324] [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: 10/04/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
The role of multiparametric magnetic resonance imaging (mpMRI) in assessing penile cancer is not well defined. However, this modality may be successfully applied for preoperative staging and patient selection; postoperative local and regional surveillance; and assessments of treatment response after oncological therapies. Previous studies have been mostly limited to a few small series evaluating the accuracy of MRI for the preoperative staging of penile cancer. This review discusses the principles of non-erectile mpMRI, including functional techniques and their applications in evaluating the male genital region, along with clinical protocols and technical considerations. The latest clinical classifications and guidelines are reviewed, focusing on imaging recommendations and discussing potential gaps and disadvantages. The development of functional MRI techniques and the extraction of quantitative parameters from these sequences enables the noninvasive assessment of phenotypic and genotypic tumor characteristics. The applications of advanced techniques in penile MRI are yet to be defined. There is a need for prospective trials and feasible multicenter trials due to the rarity of the disease, highlighting the importance of minimum technical requirements for MRI protocols, particularly image resolution, and finally determining the role of mpMRI in the assessment of penile cancer.
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Affiliation(s)
- Marta D. Switlyk
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
| | - Andreas Hopland
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
| | - Edmund Reitan
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
| | - Shivanthe Sivanesan
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
- Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
| | - Bjørn Brennhovd
- Department of Urology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (A.H.); (S.S.); (B.B.)
| | - Ulrika Axcrona
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway;
| | - Knut H. Hole
- Department of Radiology, The Norwegian Radium Hospital, Oslo University Hospital, 0379 Oslo, Norway; (E.R.); (K.H.H.)
- Institute of Clinical Medicine (KlinMED), Faculty of Medicine, University of Oslo, 0318 Oslo, Norway
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Sali AP, Shah A, Prakash G, Murthy V, Bakshi G, Joshi A, Pal M, Aggarwal A, Desai SB, Menon S. Predictors of Pelvic Lymph Nodal Metastasis in Penile Squamous Cell Carcinoma- Results from a Matched-Pair Analysis. Clin Genitourin Cancer 2022; 21:e119-e125. [DOI: 10.1016/j.clgc.2022.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
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Arora A, Rodriguez A, Necchi A, Albersen M, Zhu Y, Spiess PE, Prakash G. Global Implications in Caring for Penile Cancer: Similarities and Divergences. Semin Oncol Nurs 2022; 38:151283. [DOI: 10.1016/j.soncn.2022.151283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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RAB20 Promotes Proliferation via G2/M Phase through the Chk1/cdc25c/cdc2-cyclinB1 Pathway in Penile Squamous Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14051106. [PMID: 35267417 PMCID: PMC8909501 DOI: 10.3390/cancers14051106] [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: 12/17/2021] [Revised: 01/19/2022] [Accepted: 01/27/2022] [Indexed: 02/04/2023] Open
Abstract
RAB20, a member of the RAS GTPase oncogene family, is overexpressed in several cancers with poor outcomes, promoting tumorigenesis and inducing genomic instability. Here, we performed comprehensive genomic sequencing on eight penile squamous cell carcinoma (PSCC) and normal tissue pairs and found that RAB20 was upregulated in tumors, especially in metastatic lymph nodes. RAB20 overexpression in tumors was further verified by qPCR, Western blotting, and immunohistochemistry of our newly established PSCC cell lines and paired tissues. The clinical significance of RAB20 was validated in 259 PSCC patients, the largest cohort to date, and high RAB20 expression positively correlated with the T, N, M status, extranodal extension, and clinical stage (all p < 0.01). RAB20 was an unfavorable independent prognostic indicator in the survival analysis (p = 0.011, HR = 2.090; 95% Cl: 1.183−4.692), and PSCC patients with high RAB20 expression experienced shorter 5-year cancer-specific survival times (p < 0.001). Furthermore, tumorigenesis assays demonstrated that RAB20 knockdown inhibited cell proliferation, migration, and colony formation in vitro and tumor growth in vivo. RAB20 depletion also induced PSCC cell cycle arrest at G2/M by increasing Chk1 expression and promoting cdc25c phosphorylation to reduce cdc2-cyclinB1 complex formation. Our study revealed an oncogenic role for RAB20 in promoting PSCC cell proliferation at the G2/M phase via the Chk1/cdc25c/cdc2-cyclinB1 pathway. Thus, RAB20 could be a promising prognostic biomarker of advanced PSCC with poor patient survival outcomes and could be a potential therapeutic target.
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Sali AP, Prakash G, de Cássio Zequi S, da Costa WH, Murthy V, Soares FA, Bakshi G, Guimarães GC, Joshi A, Pal M, Desai SB, Cubilla AL, Menon S. A comparative study of AJCC and the modified staging system in pT2/pT3 penile squamous cell carcinoma- A validation on an external dataset. Histopathology 2021; 80:566-574. [PMID: 34586682 DOI: 10.1111/his.14575] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 09/25/2021] [Accepted: 09/25/2021] [Indexed: 11/27/2022]
Abstract
AIMS The recent changes in the American Joint Commission on Cancer-8th edition (AJCC-8E) pT2 and pT3 tumor definitions for penile cancer need robust validation studies. A recent study redefined and modified the pT2 and pT3 stages incorporating the histopathological variables (tumor grade, lymphovascular invasion, perineural invasion) similar to that used in the current AJCC-8E pT1 stage tumor subclassification. In this study, we validate and compare this proposed staging with the AJCC staging systems, on an external dataset. METHODS AND RESULTS The dataset from a previously published study was obtained. pT2 and pT3 stages were reconstructed as per AJCC 7th edition (AJCC-7E), AJCC-8E, and the proposed staging. The staging systems were correlated with nodal metastasis, disease-free survival (DFS), cancer-specific survival (CSS), and overall survival (OS). All systems were compared using receiver operating characteristics (ROC) curves. A total of 281 cases formed the study cohort. AJCC-8E (p=0.031) and the proposed staging (p=0.003) correlated with nodal metastasis on adjusted analysis, the latter with a better strength of association (AJCC-8E, γ= -.471, proposed, γ= -.625). On adjusted analysis, all the staging systems had a significant correlation with DFS, while only AJCC-8E and the proposed staging correlated with CSS and OS. On ROC curve analysis, the proposed staging had the highest area under the curve and was the only staging system to statistically correlate with all the outcome variables. CONCLUSIONS The proposed staging for pT2/pT3 tumor stages in penile cancer may improve the prognostic and predictive ability.
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Affiliation(s)
- Akash P Sali
- Department of Pathology, Homi Bhabha Cancer Hospital (A unit of Tata Memorial Centre), Sangrur, Punjab, India, 148001
| | - Gagan Prakash
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Stênio de Cássio Zequi
- Department of Urology, AC Camargo Cancer Center, São Paulo, Brazil, 01508-010.,National Institute for Science and Technology in Oncogenomics and Therapeutic Innovation. INCITO (CNPq/MCT/FAPESP/CAPES), São Paulo, Brazil
| | - Walter H da Costa
- Department of Urology, AC Camargo Cancer Center, São Paulo, Brazil, 01508-010
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Fernando A Soares
- D'Or Institute for Research and Education (IDOR), São Paulo, Brazil.,Faculty of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Ganesh Bakshi
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Gustavo C Guimarães
- Department of Surgical Oncology, BP - A Beneficência Portuguesa de São Paulo, São Paulo, Brazil, 01323
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Mahendra Pal
- Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Sangeeta B Desai
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
| | - Antonio L Cubilla
- Department of Pathology, Instituto de Patologia e Investigacion, Asuncion, Paraguay
| | - Santosh Menon
- Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India, 400012
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Müller T, Demes M, Lehn A, Köllermann J, Vallo S, Wild PJ, Winkelmann R. The peri- and intratumoral immune cell infiltrate and PD-L1 status in invasive squamous cell carcinomas of the penis. Clin Transl Oncol 2021; 24:331-341. [PMID: 34449004 PMCID: PMC8794908 DOI: 10.1007/s12094-021-02694-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/08/2021] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Penile carcinomas are rare tumors throughout Europe. Therefore, little attention is drawn to this disease. That makes it important to study tumor-associated key metrics and relate these to known data on penile neoplasias. MATERIALS AND METHODS A cohort of 60 well-defined penile invasive carcinomas with known human papillomavirus (HPV) infection status was investigated. Data on tumor type, grading and staging were recorded. Additionally, data on the peri- and intratumoral immune cell infiltrate in a semiquanititave manner applying an HE stain were assessed. RESULTS Our study showed a significant correlation of immune cell infiltrate and pT stage with overall survival. Therefore, in a subset of tumors, PD-L1 staining was applied. For tumor proportion score (TPS), 26 of 30 samples (87%) were scored >0%. For the immune cell score (IC), 28 of 30 samples (93%) were defined as >0% and for CPS, 29 of 30 samples (97%) scored >0. PD-L1 expression was not associated with overall survival. CONCLUSION PD-L1 is expressed in penile carcinomas, providing a rationale for targeted therapy with checkpoint inhibitors. We were able to show that immune reaction appears to be prognostically relevant. These data enhance the need for further studies on the immune cell infiltrate in penile neoplasias and show that PD-L1 expression is existent in our cohort, which may be a potential target for checkpoint inhibitor therapy.
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Affiliation(s)
- T Müller
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - M Demes
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - A Lehn
- Institute of Biostatistics and Mathematical Modeling, Goethe University, Frankfurt am Main, Germany
| | - J Köllermann
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - S Vallo
- Institute of Virology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - P J Wild
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany.,Frankfurt Institute for Advanced Studies (FIAS), Frankfurt am Main, Germany
| | - R Winkelmann
- Dr. Senckenberg Institute of Pathology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany.
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What Is New in the Pathologic Staging of Penile Carcinoma in the 8th Edition of AJCC TNM Model: Rationale for Changes With Practical Stage-by-stage Category Diagnostic Considerations. Adv Anat Pathol 2021; 28:209-227. [PMID: 34050061 DOI: 10.1097/pap.0000000000000297] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
For >50 years the tumor, node, metastasis (TNM) classification model of malignant tumors has been the main resource for clinicians, pathologists, radiologists and public health professionals ensuring a homogeneous classification and patients' management based on common staging and prognosis factors. Penile cancer was first included for staging in the third edition of the TNM classification with several changes in the last version, the 8th edition of the AJCC TNM Manual, in 2017. Some changes in the pT category were done due to recent knowledge regarding the prognostic importance of anatomical level of invasion, vascular and perineural invasion and tumor grading. These changes must be interpreted in the light of a required understanding of the complex anatomy of penile compartments especially their histological boundaries, the morphological differences of each level needed for the correct classification, the heterogeneity of penile squamous cell carcinomas and an adequate criticism of the current model used by the TNM system. We present here a series of stage-by-stage category diagnostic considerations based on the clinical experience acummulated over the years of applying the different TNM staging classifications in our large clinical practice. Some discrepancies will need well-designed prospective studies for im4proving the actual classification.
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Li Z, Li X, Lam W, Cao Y, Geng J, Ornellas AA, Zhou F, Han H. Corpora Cavernos invasion vs. Corpus Spongiosum invasion in Penile Cancer: A systematic review and meta-analysis. J Cancer 2021; 12:1960-1966. [PMID: 33753994 PMCID: PMC7974529 DOI: 10.7150/jca.56504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/05/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: Changes were made in the 8th edition of the American Joint Committee on Cancer (AJCC) staging system according to cavernosum invasion for penile squamous cell carcinoma. This study aimed to determine the difference of prognostic validity between corpora cavernosa (CC) invasion and corpus spongiosum (CS) invasion. Methods: In this study, we searched PubMed, Cochrane CENTRAL, and Embase to select English-language articles until July 15, 2020. Pooled analyses of hazard ratios (HRs) and odds ratios (ORs) were performed. Results: Eleven studies including 3692 cases were included in the final ananlysis (1431 cases with CC and 1360 cases with CS). According to the anatomical structure, the pooled results demonstrated that patients with CC invasion had a similar rate of LNM to those with CS invasion (OR 1.34, 95% confidence interval (CI) 0.97-1.86; P=0.076). However, patients with CC invasion had a higher rate of lymph node metastasis (LNM) than those with CS invasion according to the 8th edition tumor stage (OR 1.58, 95% CI 1.14-2.21; P<0.001). Regarding survival, patients with CS invasion obtained a significantly better cancer-specific survival (CSS) (HR, 0.67; 95% CI, 0.46-0.96; P=0.030), but not in overall survival (OS) (HR: 1.30; 95% CI, 0.52-3.20; P=0.585) than those with CC invasion. No a significant publication bias was observed by Begg's and Egger's tests. Conclusions: The systematic comparison suggests that patients with CS invasion had better CSS than those with CC invasion. CC invasion was associated with a high risk of LNM. The conclusions should be validated by large-scale studies.
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Affiliation(s)
- Zaishang Li
- Department of Urology, Shenzhen People's Hospital, The Second Clinic Medical College of Jinan University 518060, Shenzhen, Guangdong, P. R. China.,Department of Urology, First Affiliated Hospital of Southern University of Science and Technology, 518060, Shenzhen, Guangdong, P. R. China.,Department of Urology, Minimally Invasive Urology of Shenzhen research and Development Center of Medical Engineering and Technology, 518060, Shenzhen, Guangdong, P. R. China
| | - Xueying Li
- Department of Oncology, The Seventh Affiliated Hospital Sun Yat-sen University, 518107, Shenzhen, Guangdong, P. R. China
| | - Wayne Lam
- Division of Urology, Department of Surgery, Queen Mary's Hospital, The University of Hong Kong, 999077, Hong Kong SAR, P. R. China
| | - Yabing Cao
- Department of Oncology, Hospital Kiang Wu, 999078, Macao SAR, P. R. China
| | - Jiunhung Geng
- Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, 000800, Kaohsiung, Taiwan.,Department of Urology, Kaohsiung Medical University Hospital, 000800, Kaohsiung, Taiwan.,Kaohsiung Medical University, Kaohsiung, T 000800, Taiwan
| | - Antonio Augusto Ornellas
- Department of Urology, Brazilian National Institute of Cancer, 20230‑130, Rio de Janeiro, Brazil
| | - Fangjian Zhou
- Department of Urology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, Guangdong, P. R. China.,State Key Laboratory of Oncology in South China, 510060, Guangzhou, Guangdong, P. R. China.,Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, Guangdong, P. R. China
| | - Hui Han
- Department of Urology, Sun Yat-sen University Cancer Center, 510060, Guangzhou, Guangdong, P. R. China.,State Key Laboratory of Oncology in South China, 510060, Guangzhou, Guangdong, P. R. China.,Collaborative Innovation Center of Cancer Medicine, 510060, Guangzhou, Guangdong, P. R. China
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