752 ONCOLOGICAL OUTCOMES OF PRIMARY PENILE CANCER TREATMENT IN A UK SUPRA-REGIONAL CENTRE

Abstract

You have accessJournal of UrologyPenis/Testis/Urethra: Benign & Malignant Disease (II)1 Apr 2013752 ONCOLOGICAL OUTCOMES OF PRIMARY PENILE CANCER TREATMENT IN A UK SUPRA-REGIONAL CENTRE Rajan Veeratterapillay, Luke Teo, Susan Asterling, and Damian Greene Rajan VeeratterapillayRajan Veeratterapillay Sunderland, United Kingdom More articles by this author , Luke TeoLuke Teo Sunderland, United Kingdom More articles by this author , Susan AsterlingSusan Asterling Sunderland, United Kingdom More articles by this author , and Damian GreeneDamian Greene Sunderland, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.315AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Squamous cell carcinoma of the penis (SCC) is rare and,in the UK, is managed in supra-regional centres.There have been few reports in the literature about long-term outcomes of SCC treatment. We describe our experience over the past decade. METHODS Patients with biopsy proven penile SCC treated at our centre (Sunderland Royal Hospital, UK) in the period January 2000 to December 2010, were identified. Data were collected including stage at presentation, mode of therapy (penile preserving surgery, amputative surgery, chemo/radiotherapy), pathological findings, recurrence and cancer specific survival. Kaplan Meier (KM) analysis was performed to compare survival outcomes. RESULTS 192 patients (median age 63 years) with complete follow-up were identified.The median follow-up was 48 months. At presentation, 7 patients had metastatic disease and 31 patients had node positive disease. Initial treatment included penile preserving surgery(49%), partial penectomy(26%), radical penectomy(21%) and chemo/radiotherapy for metastatic disease(4%). 26 patients required further penile surgery due to recurrent disease. Local recurrences occurred after a median of 11.3 months and were managed by CO2 laser therapy (5%), repeat organ preserving surgical techniques (5%), or radical penectomy (4%). Histopathological staging of the final specimen showed pTis (24%), pT1 (28%), pT2 (36%), pT3 (10%) and pT4(2%). 75% of tumours were grade 2 or 3. Seventy seven patients (40%) underwent modified inguinal lymph node dissection out of whom 31 (16%) had node positive disease. 25 patients (13%) died as a result of penile cancer. KM analysis showed overall 5-year cancer specific survival of 86%. Five-year cancer specific survival was noted to decrease with advancing stage (Figure 1) with N0 tumours (92.6%), N1 (71.6%), N2 (60.6%), N3 (57.1%) and M1 (0%) [p<0.0001]. CONCLUSIONS Supra-regional penile cancer management has lead to considerable clinical experience in our centre over the past decade. Nearly half of all tumours are now managed by organ preserving techniques and overall oncological outcomes are good with a 5-year cancer specific survival of 86%. Close follow-up is vital to pick up local recurrence or progression. We confirm the association of worsening prognosis with increasing nodal and metastatic disease. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e309-e310 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rajan Veeratterapillay Sunderland, United Kingdom More articles by this author Luke Teo Sunderland, United Kingdom More articles by this author Susan Asterling Sunderland, United Kingdom More articles by this author Damian Greene Sunderland, United Kingdom More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...