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Li K, Le X, Wang J, Fan C, Sun J. Tumor Location May Independently Predict Survival in Patients With M0 Squamous Cell Carcinoma of the Penis. Front Oncol 2022; 12:927088. [PMID: 35865480 PMCID: PMC9294313 DOI: 10.3389/fonc.2022.927088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundTo determine the association between tumor location and both clinicopathological characteristics and the survival of patients with M0 squamous cell carcinoma of the penis (SCCP).MethodsData of 455 patients diagnosed with M0 SCCP between 1975 and 2018 were collected from the Surveillance, Epidemiology, and End Results (SEER) database of the United States National Cancer Institute. The effects of tumor location on overall survival (OS) and penile carcinoma-specific survival (PCSS) were analyzed using the Kaplan–Meier method. The Cox proportional hazards regression model was used to determine the impact of tumor location on PCSS.ResultsSCCP was more likely to occur in the prepuce or glans (90%). Although no significant difference was observed between the OS of patients with M0 SCCP in the prepuce or glans and those with M0 SCCP in the body of the penis (p = 0.307), the former had better PCSS (p = 0.024). Moreover, M0 SCCP in the prepuce or glans was also significantly associated with better PCSS in patients with advanced age (age ≥ 60 years, p = 0.011), other ethnicities (p = 0.003), T2–T4 stage (p = 0.036), larger tumors (≥3 cm, p = 0.001), no regional lymph nodes removed (p = 0.044), and radical surgery (p = 0.027). Multivariate analysis confirmed that tumor location is an independent prognostic factor for patients with M0 SCCP [hazard ratio (HR) 1.881, p = 0.026].ConclusionsTumor location is an independent prognostic factor for patients with M0 SCCP, and tumors in the prepuce or glans portend better PCSS.
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Affiliation(s)
| | | | | | - Caibin Fan
- *Correspondence: Caibin Fan, ; Jian Sun,
| | - Jian Sun
- *Correspondence: Caibin Fan, ; Jian Sun,
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Clinical Application of Noninflating Video-Endoscopic Inguinal Lymph Node Dissection. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8259990. [PMID: 35799632 PMCID: PMC9256332 DOI: 10.1155/2022/8259990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/12/2022] [Accepted: 06/16/2022] [Indexed: 11/29/2022]
Abstract
Objective To assess the safety and efficacy of the application of self-made non-inflating suspension technique in video endoscopic inguinal lymph node dissection (ILND). Methods We collected 8 patients with penile carcinoma who underwent noninflating video-endoscopic ILND in the Department of Urology, the First Affiliated Hospital of Anhui Medical University, from May 2019 to March 2021. Then, surgical duration, blood loss, drainage tube indwelling time, hospital stay, number of dissected lymph nodes, and complications in the patients were analyzed. Results All patients (n = 8) finished the surgery successfully, with an average surgical duration of 125 (105-145) minutes, blood loss of 41 (25-50) mL, indwelling time of drainage tube of 7 (5-12) days, and a hospital stay of 14.8 (9-21) days. Additionally, 8.8 (3-14) left side and 7.3 (2-17) right side lymph nodes were dissected on average. Complications occurred in 3 patients during a perioperative period. The patients were followed up for 6-24 months, and none suffered recurrence or metastasis. Conclusion The efficacy of noninflating video-endoscopic ILND is good. Patients who have undergone the surgery not only have few postoperative complications but also have a good prognosis, suggesting the safety and availability of the clinical application.
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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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Li H, Ma Y, Jian Z, Jin X, Xiang L, Li H, Wang K. Lymph Node Dissections for T3T4 Stage Penile Cancer Patients Without Preoperatively Detectable Lymph Node Metastasis Bring More Survival Benefits: A Propensity Matching Analysis. Front Oncol 2021; 11:712553. [PMID: 34631537 PMCID: PMC8497980 DOI: 10.3389/fonc.2021.712553] [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: 05/20/2021] [Accepted: 09/06/2021] [Indexed: 02/05/2023] Open
Abstract
Background and Aims The current guidelines for the treatment of penile cancer patients with clinically non-invasive normal inguinal lymph nodes are still broad, so the purpose of this study is to determine which patients are suitable for lymph node dissection (LND). Methods Histologically confirmed penile cancer patients (primary site labeled as C60.9-Penis) from 2004 to 2016 in the Surveillance, Epidemiology, and Results database were included in this analysis. Univariate and multivariate Cox regression analyses were applied to determine an overall estimate of LND on overall survival and cancer-specific survival. A 1:1 propensity matching analysis (PSM) was applied to enroll balanced baseline cohort, and further Kaplan-Meier (KM) survival analysis was used to get more reliable results. Results Out of 4,458 histologically confirmed penile cancer patients with complete follow-up information, 1,052 patients were finally enrolled in this analysis. Age, pathological grade, T stage, and LND were identified as significant predictors for overall survival (OS) in the univariate Cox analysis. In the multivariate Cox regression, age, pathological grade, T stage, and LND were found significant. The same results were also found in the univariate and multivariate Cox regression analyses for cancer-specific survival (CSS). After the successful PSM, further KM analysis revealed that LND could bring significant OS and CSS benefits for T3T4 patients without lymph node metastasis. Conclusion Lymph node dissection may bring survival benefits for penile cancer patients without preoperatively detectable lymph node metastasis, especially for T3T4 stage patients. Further randomized control trial is needed.
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Affiliation(s)
- Han Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China.,Department of Urology, Chengdu No. 5 People's Hospital, Chengdu, China
| | - Yucheng Ma
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Zhongyu Jian
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Xi Jin
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Liyuan Xiang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Hong Li
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
| | - Kunjie Wang
- Department of Urology, Institute of Urology (Laboratory of Reconstructive Urology), West China Hospital, Sichuan University, Chengdu, China
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5
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Draeger DL, Groh S, Buchholz T, Woehl M, Nolting J, Hakenberg OW. Prediction of Treatment Response and Survival with Chemotherapy for Metastatic Penile Cancer by the Modified Glasgow Prognostic Score. Urol Int 2021; 107:489-495. [PMID: 34610603 DOI: 10.1159/000519358] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 08/06/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE There is increasing evidence that a persistent systemic inflammatory response predicts lower survival in patients with malignant disease. The modified Glasgow Prognostic Score (mGPS) is defined by a combination of elevated C-reactive protein (CRP) (>10 mg/L) and hypoalbuminemia (<35 g/L). It is considered as an independent prognostic marker in several organ malignancies. The aim of this study was to investigate the value of mGPS in metastatic penile carcinoma in predicting treatment response and survival. METHODS One hundred and fifty-six patients with penile carcinoma treated with chemotherapy were included in this retrospective study. The mGPS before chemotherapy was classified into 3 groups (mGPS 0 [CRP <10, any albumin], mGPS 1 [CRP >10 mg/L, albumin >35 g/L], and mGPS 2 [CRP >10 mg/L, albumin <35 g/L]). Overall survival and disease-free survival were calculated by Kaplan-Meier analysis and chemotherapy toxicity by CTC criteria. Univariate Cox proportional hazards models were calculated to estimate the effect of each predictor on OS and DFS. RESULTS Survival was significantly different in the 3 mGPS classes, with mGPS 0 patients showing the best treatment response and survival. Univariate analysis showed that mGPS (p < 0.0001), tumor stage (p = 0.004), and venous and lymphatic invasion (p = 0.011) were factors independently associated with prognosis. The response to chemotherapy differed significantly between mGPS groups (mGPS 0, 36/51 [71%]; mGPS 1, 24/70 [34%]; mGPS 2, 9/35 [26%], p = 0.03 and p = 0.37, respectively). mGPS was significantly associated with chemotherapy-associated toxicity, with treatment adaptation (p < 0.01) and toxicity-related deaths (p = 0.028). CONCLUSIONS Systemic inflammatory response and nutritional status as expressed by the mGPS are independent predictors of treatment response, chemotherapy-associated toxicity, and survival in metastatic penile carcinoma. In addition to other known pathological markers of tumor aggressiveness, the mGPS can be used as a clinical predictor of prognosis.
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Affiliation(s)
| | - Sophie Groh
- Department of Urology, Medical University of Rostock, Rostock, Germany
| | - Tim Buchholz
- Department of Urology, Medical University of Rostock, Rostock, Germany
| | - Maria Woehl
- Department of Urology, Medical University of Rostock, Rostock, Germany
| | - Julia Nolting
- Department of Urology, Medical University of Rostock, Rostock, Germany
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Soares A, de Carvalho IT, da Fonseca AG, Alencar AM, Leite CHB, Bastos DA, Soares JPH, Leite KRM, Filho MRB, Coelho RWP, Cavallero SRDA, de Cassio Zequi S, de Ribamar Rodrigues Calixto J. Penile cancer: a Brazilian consensus statement for low- and middle-income countries. J Cancer Res Clin Oncol 2020; 146:3281-3296. [PMID: 33104884 PMCID: PMC7679332 DOI: 10.1007/s00432-020-03417-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/29/2020] [Indexed: 02/05/2023]
Abstract
Purpose Penile cancer is highly prevalent in low- and middle-income countries, with significant morbidity and mortality rates. The first Brazilian consensus provides support to improve penile cancer patients’ outcomes, based on expert’s opinion and evidence from medical literature. Methods Fifty-one Brazilian experts (clinical oncologists, radiation oncologists, urologists, and pathologists) assembled and voted 104 multiple-choice questions, confronted the results with the literature, and ranked the levels of evidence. Results Healthcare professionals need to deliver more effective communication about the risk factors for penile cancer. Staging and follow-up of patients include physical examination, computed tomography, and magnetic resonance imaging. Close monitoring is crucial, because most recurrences occur in the first 2–5 years. Lymph-node involvement is the most important predictive factor for survival, and management depends on the location (inguinal or pelvic) and the number of lymph nodes involved. Conservative treatment may be helpful in selected patients without compromising oncological outcomes; however, surgery yields the lowest rate of local recurrence. Conclusion This consensus provides an essential decision-making orientation regarding this challenging disease. Electronic supplementary material The online version of this article (10.1007/s00432-020-03417-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrey Soares
- Department of Oncology, Centro Paulista de Oncologia-Oncoclínicas, Av. Brigadeiro Faria Lima, 4300, Vila Olímpia, São Paulo, SP, 01452-000, Brazil. .,Department of Oncology, Hospital Israelita Albert Einstein, Av. Albert Einstein, 627, Morumbi, São Paulo, SP, 05652-900, Brazil. .,Latin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, Brazil.
| | - Icaro Thiago de Carvalho
- Department of Radiotherapy, Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.,Instituto Abathon, São Paulo, São Paulo, Brazil
| | | | - Antonio Machado Alencar
- Department of Oncology, Hospital Universitário da Universidade Federal do Maranhão, São Luís, Maranhão, Brazil.,Department of Oncology, Hospital São Domingos, São Luís, Maranhão, Brazil
| | | | - Diogo Assed Bastos
- Latin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Oncology, Hospital Sírio-Libanês, São Paulo, São Paulo, Brazil
| | | | - Katia Ramos Moreira Leite
- Medical Research Laboratory of the Discipline of Urology, Faculdade de Medicina da USP, São Paulo, São Paulo, Brazil
| | | | - Ronald Wagner Pereira Coelho
- Latin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Oncology, Hospital do Câncer Aldenora Bello, São Luís, Maranhão, Brazil
| | - Sandro Roberto de A Cavallero
- Latin American Cooperative Oncology Group, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Oncology, Hospital Adventista de Belém, Belém, Pará, Brazil.,Department of Oncology, Centro de Tratamento Do Pará, Belém, Pará, Brazil
| | - Stênio de Cassio Zequi
- Department of Urology, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil.,National Institute for Science and Technology in Oncogenomics and Therapeutic Innovation, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
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7
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Ghahhari J, Marchioni M, Spiess PE, Chipollini JJ, Nyirády P, Varga J, Ditonno P, Boccasile S, Primiceri G, De Nunzio C, Tema G, Tubaro A, Veccia A, Antonelli A, Musi G, De Cobelli O, Conti A, Puliatti S, Micali S, Álvarez-Maestro M, Quesada Olarte J, Diogenes E, Lima MVA, Tracey A, Guruli G, Autorino R, Sountoulides P, Sosnowski R, Schips L, Cindolo L. Radical penectomy, a compromise for life: results from the PECAD study. Transl Androl Urol 2020; 9:1306-1313. [PMID: 32676414 PMCID: PMC7354339 DOI: 10.21037/tau.2020.04.04] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background The use of organ sparing strategies to treat penile cancer (PC) is currently supported by evidence that has indicated the safety, efficacy and benefit of this surgery. However, radical penectomy still represents up to 15-20% of primary tumor treatments in PC patients. The aim of the study was to evaluate efficacy in terms of overall survival (OS) and disease-free survival (DFS) of radical penectomy in PC patients. Methods Data from a retrospective multicenter study (PEnile Cancer ADherence study, PECAD Study) on PC patients treated at 13 European and American urological centers (Hospital "Sant'Andrea", Sapienza University, Roma, Italy; "G.D'Annunzio" University, Chieti and ASL 2 Abruzzo, Hospital "S. Pio da Pietrelcina", Vasto, Italy; Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA; Hospital of Budapest, Hungary; Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Italy; Hospital "Spedali Civili", Brescia, Italy; Istituto Europeo di Oncologia, University of Milan, Milan, Italy; University of Modena & Reggio Emilia, Modena, Italy; Hospital Universitario La Paz, Madrid, Spain; Ceara Cancer Institute, Fortaleza, Brazil; Virginia Commonwealth University, Richmond, VA, USA; Aristotle University of Thessaloniki, Thessaloniki, Greece; Maria Skłodowska-Curie Memorial Cancer Center, Warsaw, Poland) between 2010 and 2016 were used. Medical records of patients who specifically underwent radical penectomy were reviewed to identify main clinical and pathological variables. Kaplan-Meier method was used to estimate 1- and 5-year OS and DFS. Results Of the entire cohort of 425 patients, 72 patients (16.9%) treated with radical penectomy were extracted and were considered for the analysis. The median age was 64.5 (IQR, 57.5-73.2) years. Of all, 41 (56.9%) patients had pT3/pT4 and 31 (43.1%) pT1/pT2. Moreover, 36 (50.0%) were classified as pN1-3 and 5 (6.9%) M1. Furthermore, 61 (84.7%) had a high grade (G2-G3) with 6 (8.3%) positive surgical margins. The 1- and 5-year OS rates were respectively 73.3% and 59.9%, while the 1- and 5-year DFS rates were respectively 67.3% and 35.1%. Conclusions PC is an aggressive cancer particularly in more advanced stage. Overall, more than a third of patients do not survive at 5 years and more than 60% report a disease recurrence, despite the use of a radical treatment.
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Affiliation(s)
- Jamil Ghahhari
- Department of Urology, Hospital "Sant'Andrea", Sapienza University, Roma, Italy
| | | | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Juan J Chipollini
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Peter Nyirády
- Department of Urology, Hospital of Budapest, Budapest, Hungary
| | - Judith Varga
- Department of Urology, Hospital of Budapest, Budapest, Hungary
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | - Stefano Boccasile
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | | | - Cosimo De Nunzio
- Department of Urology, Hospital "Sant'Andrea", Sapienza University, Roma, Italy
| | - Giorgia Tema
- Department of Urology, Hospital "Sant'Andrea", Sapienza University, Roma, Italy
| | - Andrea Tubaro
- Department of Urology, Hospital "Sant'Andrea", Sapienza University, Roma, Italy
| | | | | | - Gennaro Musi
- Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Ottavio De Cobelli
- Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Andrea Conti
- Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Stefano Puliatti
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena & Reggio Emilia, Modena, Italy
| | | | | | - Erico Diogenes
- Department of Urology, Ceara Cancer Institute, Fortaleza, Brazil
| | | | - Andrew Tracey
- Department of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Georgi Guruli
- 1st Urology Department Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Riccardo Autorino
- Department of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Petros Sountoulides
- 1st Urology Department Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Roman Sosnowski
- Department of Uro-Oncology, Maria Skłodowska-Curie Memorial Cancer Center, Warsaw, Poland
| | - Luigi Schips
- Department of Urology, "G.D'Annunzio" University, Chieti, Italy
| | - Luca Cindolo
- Department of Urology, ASL 2 Abruzzo, Hospital "S. Pio da Pietrelcina", Vasto, Italy
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Racial/ethnic disparities in penile squamous cell carcinoma incidences, clinical characteristics, and outcomes: A population-based study, 2004-2016. Urol Oncol 2020; 38:688.e11-688.e19. [PMID: 32340796 DOI: 10.1016/j.urolonc.2020.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 02/23/2020] [Accepted: 03/05/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE This study assessed the impact of race/ethnicity on penile squamous cell carcinoma (PSCC) incidence rates, clinical characteristics, and outcomes. MATERIALS AND METHODS Surveillance, Epidemiology and End Results data from 2004 to 2016 was used for this study. We evaluated racial/ethnic differences in clinical characteristics using χ2 tests. Overall survival (OS) and PSCC-specific survival (PSCC-SS) were estimated using the Kaplan-Meier method, and differences were determined using the log-rank test. Cox regression models were performed to assess independent predictors for PSCC patient survival. RESULTS A total of 2,720 PSCC patients were included for incidence analysis, and 2,438 patients were identified for the χ2 testing and survival analyses.The overall incidence of PSCC during 2004 to 2016 was 0.30 per 100,000. Only non-Hispanic white (NHW) patients had a statistically significant increase in age-adjusted incidence rates (annual percent change = 2.26, 95% confidence interval [CI]: 0.78-3.76; P = 0.01). In univariate analysis, race/ethnicity was an independent prognostic factor for OS and PSCC-SS. After adjusting for age, marital status, income, grade, TNM (tumor, node, metastasis) stage, and treatment strategies, non-Hispanic black patients still had a statistically significant hazard ratio of 1.35 (95% CI: 1.08-1.68; P = 0.007) for OS, and a hazard ratio of 1.36 (95% CI: 1.01-1.82; P = 0.045) for PSCC-SS compared to NHW. CONCLUSION NHW patients had a statistically significant increase in age-adjusted incidence rate during the period 2004 to 2016. Race/ethnicity is an independent prognostic factor for OS and PSCC-SS, and non-Hispanic black were proven to have unfavorable OS and PSCC-SS compared with NHW.
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Mistretta FA, Mazzone E, Palumbo C, Knipper S, Tian Z, Nazzani S, Tilki D, Musi G, Perrotte P, Montanari E, Shariat SF, Saad F, Briganti A, de Cobelli O, Karakiewicz PI. Adherence to guideline recommendations for lymph node dissection in squamous cell carcinoma of the penis: Effect on survival and complication rates. Urol Oncol 2019; 37:578.e11-578.e19. [DOI: 10.1016/j.urolonc.2019.05.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/29/2019] [Accepted: 05/31/2019] [Indexed: 11/16/2022]
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10
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Li K, Sun J, Wei X, Wu G, Wang F, Fan C, Yuan H. Prognostic value of lymphovascular invasion in patients with squamous cell carcinoma of the penis following surgery. BMC Cancer 2019; 19:476. [PMID: 31113402 PMCID: PMC6528249 DOI: 10.1186/s12885-019-5714-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Accepted: 05/14/2019] [Indexed: 12/16/2022] Open
Abstract
Background To evaluate the prognostic value of Lymphovascular Invasion (LVI) in patients with squamous cell carcinoma of the penis (SCCP) following surgery. Patients and methods This retrospective study analyzed the data of 891 eligible patients with SCCP who were diagnosed between 2010 and 2014, obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were categorized by LVI, age, grade, T stage, lymph nodes status, distant metastasis, regional lymph nodes removed, and surgery. Overall survival (OS) and penile carcinoma-specific survival (PCSS) were evaluated by Kaplan-Meier method and Cox proportional hazards regression model. Results The presence of LVI was significantly associated with increased risk of advanced T stage, high grade, lymph node metastasis, and distant metastasis (P < 0.001 for all). In Kaplan-Meier analyses, patients with the presence of LVI had significantly lower OS and PCSS than those with the absence of LVI (P < 0.001 for both,). The presence of LVI was also significantly associated with poorer OS and worse PCSS in patients with Tx + Ta + T1 stage (P = 0.007, P < 0.001), N0 stage (P < 0.001, P = 0.040), grade 1 (P = 0.001, P < 0.001), grade 2 (P = 0.001, P = 0.014), no distant metastasis (P < 0.001 for both), no regional lymph nodes removed (P < 0.001 for both), Non-radical surgery (P < 0.001 for both) and radical surgery(P = 0.037, P = 0.002). In multivariate analyses, the presence of LVI in patients with SCCP following surgery was found to be a significant independent predictor of decreased OS (hazard ratio 1.403, P = 0.039). Conclusions The LVI status might be a crucial prognostic indicator for overall survival in patients with SCCP.
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Affiliation(s)
- Kai Li
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Jian Sun
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Xuedong Wei
- Department of Urology, First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Guang Wu
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Fei Wang
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China
| | - Caibin Fan
- Department of Urology, Suzhou Municipal Hospital, 26 Daoqian Road, Suzhou, 215000, Jiangsu Province, People's Republic of China.
| | - Hexing Yuan
- Department of Urology, First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou, 215000, Jiangsu Province, People's Republic of China.
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11
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Cindolo L, Spiess PE, Bada M, Chipollini JJ, Nyirády P, Chiodini P, Varga J, Ditonno P, Battaglia M, De Nunzio C, Tema G, Veccia A, Antonelli A, Musi G, De Cobelli O, Conti A, Micali S, Álvarez-Maestro M, Olarte JQ, Diogenes E, Lima MVA, Tracey A, Guruli G, Autorino R, Sountoulides P, Schips L. Adherence to EAU guidelines on penile cancer translates into better outcomes: a multicenter international study. World J Urol 2018; 37:1649-1657. [PMID: 30377813 DOI: 10.1007/s00345-018-2549-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 10/25/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION We aimed to evaluate adherence to the EAU guidelines (GL) on penile cancer (PC) with regard to primary surgical treatment and management of lymph nodes and to estimate the influence of adherence to GL on clinical outcome. MATERIALS AND METHODS This is a retrospective multicenter study (PEnile Cancer ADherence study, PECAD Study) on PC patients treated at 12 European and American centers between 2010 and 2016. Adherence to the EAU GL on the surgical management of the primary penile tumor and lymphadenectomy was evaluated. Descriptive analyses were performed, and survival curves were estimated. RESULTS Data on 425 patients were considered for the analysis. The EAU GL on surgical treatment of the primary tumor and lymphadenectomy were respected in 74.8% and 73.7% of cases, respectively. Survival analysis showed that adherence to the GL on primary penile surgery was significantly associated with a good overall survival [adjusted HR 0.40 (95% CI 0.20-0.83, p value = 0.014)]. Also, the adherence to the GL on lymphadenectomy was statistically significantly associated with overall survival [adjusted HR 0.48 (95% CI 0.24-0.96, p value = 0.038)]. Limited follow-up and retrospective design represent limitations of this study. CONCLUSIONS Our findings suggest that there is a good adherence to the EAU GL on PC. However, this should be further reinforced, endorsed and encouraged as it might translate into better clinical outcomes for PC patients.
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Affiliation(s)
- Luca Cindolo
- Department of Urology, ASL 2 Abruzzo, Hospital "S. Pio da Pietrelcina", Vasto, Italy.
| | - Philippe E Spiess
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Maida Bada
- Department of Urology, ASL 2 Abruzzo, Hospital "S. Pio da Pietrelcina", Vasto, Italy
| | - Juan J Chipollini
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Peter Nyirády
- Department of Urology, Hospital of Budapest, Budapest, Hungary
| | - Paolo Chiodini
- Medical Statistics Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Judith Varga
- Department of Urology, Hospital of Budapest, Budapest, Hungary
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation, Urology and Andrology Unit II, University of Bari, Bari, Italy
| | - Cosimo De Nunzio
- Department of Urology, Hospital "Sant' Andrea", Sapienza University, Rome, Italy
| | - Giorgia Tema
- Department of Urology, Hospital "Sant' Andrea", Sapienza University, Rome, Italy
| | | | | | - Gennaro Musi
- Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Ottavio De Cobelli
- Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Andrea Conti
- Department of Urology, Istituto Europeo di Oncologia, University of Milan, Milan, Italy
| | - Salvatore Micali
- Department of Urology, University of Modena and Reggio Emilia, Modena, Italy
| | | | | | - Erico Diogenes
- Department of Urology, Ceara Cancer Institute, Fortaleza, Brazil
| | | | - Andrew Tracey
- Department of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Georgi Guruli
- Department of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | - Riccardo Autorino
- Department of Urology, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Luigi Schips
- Department of Urology, "G.D'Annunzio" University, Chieti, Italy
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12
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Takamoto D, Kawahara T, Kasuga J, Sasaki T, Yao M, Yumura Y, Uemura H. The analysis of human papillomavirus DNA in penile cancer tissue by in situ hybridization. Oncol Lett 2018; 15:8102-8106. [PMID: 29731917 DOI: 10.3892/ol.2018.8351] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 01/11/2018] [Indexed: 12/13/2022] Open
Abstract
Primary penile cancer is a rare disease. Higher incidence rates occur in underdeveloped countries. Many studies have suggested an association between human papillomavirus (HPV) infection and penile cancer. Although HPV can affect the squamous epithelium of the male genitalia similarly to the female genital tract, the association between penile cancer and HPV remains unclear. In the present study, the HPV gene expression was examined in penile cancer tissue using in situ hybridization (ISH). The present study included 41 cases in which penectomy was performed and 3 cases in which tumor resection was performed to treat pathologically-diagnosed penile cancer at Yokohama City University Medical Center, and its 7 affiliated hospitals between April 1990 and March 2010. The penile cancer tissue was subjected to an ISH analysis, and the clinicopathological features and prognosis were investigated. A total of 5/44 cases (11.4%) showed the expression of high-risk HPV. None of the patients showed the expression of low-risk HPV. The associations between the expression of high-risk HPV, and age, tumor location, tumor size, T stage, pathological differentiation, nuclear grade, Broder's classification, pattern of invasion, Y-K grade, vascular invasion, lymphoid invasion, koilocytosis and lymph-node metastasis were then examined. Patients with a well-differentiated status (P=0.044) and Broder's Grade 1 (P=0.019) showed a significantly lower rate of HPV positivity. The HPV expression was not significantly associated with cancer specific survival (P=0.932). ISH using INFORM HPV III does not detect the HPV genotype, this method is easy to employ and may be useful for the diagnosis of penile cancer tissue, similarly to cervical cancer.
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Affiliation(s)
- Daiji Takamoto
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Kanagawa 2360004, Japan
| | - Takashi Kawahara
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Kanagawa 2360004, Japan.,Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 2320024, Japan
| | - Jun Kasuga
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Kanagawa 2360004, Japan
| | - Takeshi Sasaki
- Department of Hospital Coordinate Promotion and Telepathology, Tokyo University Hospital, Tokyo 1138655, Japan
| | - Masahiro Yao
- Department of Urology, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 2320024, Japan
| | - Yasushi Yumura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Kanagawa 2360004, Japan
| | - Hiroji Uemura
- Department of Urology and Renal Transplantation, Yokohama City University Medical Center, Yokohama, Kanagawa 2360004, Japan
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13
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Aita GA, Zequi SDC, Costa WHD, Guimarães GC, Soares FA, Giuliangelis TS. Tumor histologic grade is the most important prognostic factor in patients with penile cancer and clinically negative lymph nodes not submitted to regional lymphadenectomy. Int Braz J Urol 2017; 42:1136-1143. [PMID: 27813383 PMCID: PMC5117969 DOI: 10.1590/s1677-5538.ibju.2015.0416] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 03/21/2016] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION The presence and extension of inguinal lymph node metastasis are the main prognostic factors in patients with penile cancer. Physical exam and image exams are not adequate to evaluate inguinal lymph nodes and many patients are submitted to non-therapeutic lymphadenectomies. However, it is known that not all patients with clinically or histologically negative inguinal lymph nodes evolve favorably. CASUISTIC AND METHODS the authors evaluated the clinical and pathologic characteristics of 163 patients with penile carcinoma and clinically negative inguinal lymph nodes followed for three or more years and their impact on global survival (GS) and cancer-specific survival (CSS) in the 10-year follow-up. Primary pathologic tumor stage (p=0.025) and the presence of high grade of tumor differentiation (p=0.018) were predictive of CSS. The presence of high grade tumor was an independent specific prognostic factor of death risk (RR 14.08; p=0.019). CONCLUSION high histologic grade was an independent predictive factor of specific death risk in patients with penile carcinoma and clinically negative lymph nodes followed for three or more years.
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Affiliation(s)
- Giuliano Amorim Aita
- Departamento de Urologia, Hospital Universitário - Universidade Federal do Piauí, Brasil
| | - Stênio de Cássio Zequi
- Serviço de Urologia, Departamento de Cirurgia Pélvica, A C Camargo Cancer Center, SP, Brasil
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14
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Marchi FA, Martins DC, Barros-Filho MC, Kuasne H, Busso Lopes AF, Brentani H, Trindade Filho JCS, Guimarães GC, Faria EF, Scapulatempo-Neto C, Lopes A, Rogatto SR. Multidimensional integrative analysis uncovers driver candidates and biomarkers in penile carcinoma. Sci Rep 2017; 7:6707. [PMID: 28751665 PMCID: PMC5532302 DOI: 10.1038/s41598-017-06659-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 06/19/2017] [Indexed: 01/24/2023] Open
Abstract
Molecular data generation and their combination in penile carcinomas (PeCa), a significant public health problem in poor and underdeveloped countries, remain virtually unexplored. An integrativemethodology combin ing genome-wide copy number alteration, DNA methylation, miRNA and mRNA expression analysis was performed in a set of 20 usual PeCa. The well-ranked 16 driver candidates harboring genomic alterations and regulated by a set of miRNAs, including hsa-miR-31, hsa-miR-34a and hsa-miR-130b, were significantly associated with over-represented pathways in cancer, such as immune-inflammatory system, apoptosis and cell cycle. Modules of co-expressed genes generated from expression matrix were associated with driver candidates and classified according to the over-representation of passengers, thus suggesting an alteration of the pathway dynamics during the carcinogenesis. This association resulted in 10 top driver candidates (AR, BIRC5, DNMT3B, ERBB4, FGFR1, PML, PPARG, RB1, TNFSF10 and STAT1) selected and confirmed as altered in an independent set of 33 PeCa samples. In addition to the potential driver genes herein described, shorter overall survival was associated with BIRC5 and DNMT3B overexpression (log-rank test, P = 0.026 and P = 0.002, respectively) highlighting its potential as novel prognostic marker for penile cancer.
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Affiliation(s)
| | - David Correa Martins
- Center of Mathematics, Computing and Cognition, Federal University of ABC - UFABC, Santo André, SP, Brazil
| | | | | | | | - Helena Brentani
- Department of Psychiatry, Medical School, University of Sao Paulo - USP, São Paulo, SP, Brazil
| | | | | | - Eliney F Faria
- Department of Urology, Barretos Cancer Hospital, Barretos, São Paulo, Brazil
| | | | - Ademar Lopes
- A.C.Camargo Cancer Center, São Paulo, SP, Brazil
| | - Silvia Regina Rogatto
- Department of Urology, Faculty of Medicine, Sao Paulo State University - UNESP, Botucatu, SP, Brazil.
- Department of Clinical Genetics, Vejle Hospital and Institute of Regional Health, University of Southern Denmark, Odense, Denmark.
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15
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Campbell RA, Slopnick EA, Ferry EK, Zhu H, Kim SP, Abouassaly R. Disparity between pre-existing management of penile cancer and NCCN guidelines. Urol Oncol 2017; 35:531.e9-531.e14. [PMID: 28363474 DOI: 10.1016/j.urolonc.2017.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 01/13/2017] [Accepted: 03/01/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To determine the locoregional management of penile cancer before the introduction of NCCN guidelines and how much shift in practice patterns is required to meet the guidelines. METHODS The National Cancer Data Base was queried to identify 6,396 patients with squamous cell carcinoma of the penis diagnosed between 2004 and 2013. The cohort was divided into management groups based on the NCCN guidelines: cTa and cTis (cTa/is), pT1 low grade (T1LG), pT1 high grade (T1HG), and pT2 or greater (T234). These groups were analyzed to determine if management of locoregional disease complies with the 2016 NCCN guidelines and logistic regression analyses were performed to determine factors associated with adherence. RESULTS Nationwide management of the primary tumor closely follows the NCCN guidelines, with 96.9% adherence for cTa/is, 91.4% for T1LG, and 94.2% for T234. Management of regional lymph nodes (LNs) was inadequate with only 62.9% of patients with clinical N1 or N2 disease undergoing regional LN dissection (LND). The percentage of patients with known LN metastases who received regional LND increased over time (46.2% in 2004 to 69.4% in 2013, P = 0.034). Patients treated at community cancer programs (odds ratio [OR] = 0.26, 95% CI: 0.19-0.35), comprehensive community cancer programs (OR = 0.34, 95% CI: 0.29-0.41), and integrated network cancer programs (OR = 0.36, 95% CI: 0.25-0.52) were significantly less likely to receive LND compared with patients treated at academic comprehensive cancer programs. CONCLUSIONS Before the introduction of NCCN guidelines, national practice patterns for the management of the primary tumor were consistent with the recommendations. However, the management of regional LNs deviated from the guidelines, reflecting an area for improvement.
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Affiliation(s)
- Rebecca A Campbell
- Department of Urology, UH Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Emily A Slopnick
- Department of Urology, UH Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Elizabeth K Ferry
- Department of Urology, UH Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Hui Zhu
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH; Division of Urology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH
| | - Simon P Kim
- Department of Urology, UH Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH
| | - Robert Abouassaly
- Department of Urology, UH Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH; Division of Urology, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland, OH.
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16
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Management of Penile Cancer. Urology 2016; 96:15-21. [DOI: 10.1016/j.urology.2015.12.041] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 12/14/2015] [Accepted: 12/22/2015] [Indexed: 12/17/2022]
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