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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Reis ST, Viana NI, Leite KRM, Diogenes E, Antunes AA, Iscaife A, Nesrallah AJ, Passerotti CC, Srougi V, Pontes-Junior J, Salles ME, Nahas WC, Srougi M. Role of Genetic Polymorphisms in the Development and Prognosis of Sporadic and Familial Prostate Cancer. PLoS One 2016; 11:e0166380. [PMID: 27906997 PMCID: PMC5132395 DOI: 10.1371/journal.pone.0166380] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 10/27/2016] [Indexed: 01/03/2023] Open
Abstract
Backgrounds Our aim was to evaluate the role of 20 genetic polymorphisms in the development and prognosis of sporadic and familial PC. A case-control study of 185 patients who underwent radical prostatectomy from 1997 to 2011. These patients were divided into two groups based on their family history. Gleason grade, PSA value and pathological TNM 2002 stage were used as prognostic factors. Blood samples from 70 men without PC were used as controls. The SNPs were genotyped using a TaqMan® SNP Genotyping Assay Kit. Results Considering susceptibility, the polymorphic allele in the SNP rs2660753 on chromosome 3 was significantly more prevalent in controls (p = 0.01). For familial clustering, the polymorphic homozygote genotype of the SNP rs7931342 was five times more frequent in patients with familial PC compared to sporadic PC (p = 0.01). Regarding the SNP 1447295, the polymorphic homozygote genotype was more prevalent in patients with organ-confined PC (p = 0.05), and most importantly, the polymorphic allele occurred more frequently in patients without biochemical recurrence (p = 0.01). Kaplan-Meier analysis showed a median biochemical recurrence free survival of 124.2 compared to 85.6 months for patients with the wild-type allele (p = 0.007). Conclusion Our findings provide the evidence for the association of 20 recently highlighted SNPs and their susceptibility, familial clustering, staging, Gleason score and biochemical recurrence of PC. We believe that the association between these SNPs and PC may contribute to the development of alternative tools that can facilitate the early detection and prognosis of this disease.
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Affiliation(s)
- Sabrina T Reis
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Nayara I Viana
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Katia R M Leite
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Erico Diogenes
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alberto A Antunes
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Alexandre Iscaife
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Adriano J Nesrallah
- Uro-Oncology Group, Urology Department, University of Sao Paulo Medical School and Institute of Cancer Estate of Sao Paulo (ICESP), Sao Paulo, Brazil
| | - Carlo C Passerotti
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Victor Srougi
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - José Pontes-Junior
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil.,Uro-Oncology Group, Urology Department, University of Sao Paulo Medical School and Institute of Cancer Estate of Sao Paulo (ICESP), Sao Paulo, Brazil
| | - Mary Ellen Salles
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - William C Nahas
- Uro-Oncology Group, Urology Department, University of Sao Paulo Medical School and Institute of Cancer Estate of Sao Paulo (ICESP), Sao Paulo, Brazil
| | - Miguel Srougi
- Laboratory of Medical Investigation (LIM55), Urology Department, University of Sao Paulo Medical School, Sao Paulo, Brazil
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