MP50-02 RISK OF LOCAL RECURRENCE IN MEN WITH PENILE INTRAEPITHELIAL NEOPLASIA (PEIN) IN THE SURGICAL MARGIN AFTER PENILE SPARING SURGERY

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP50-02 RISK OF LOCAL RECURRENCE IN MEN WITH PENILE INTRAEPITHELIAL NEOPLASIA (PEIN) IN THE SURGICAL MARGIN AFTER PENILE SPARING SURGERY Luca Antonelli, Esther W. C. Lee, Allaudin Issa, James Churchill, Pedro Oliveira, Maurice Lau, Vijay Sangar, Arie Parnham, and Christian D. Fankhauser Luca AntonelliLuca Antonelli More articles by this author , Esther W. C. LeeEsther W. C. Lee More articles by this author , Allaudin IssaAllaudin Issa More articles by this author , James ChurchillJames Churchill More articles by this author , Pedro OliveiraPedro Oliveira More articles by this author , Maurice LauMaurice Lau More articles by this author , Vijay SangarVijay Sangar More articles by this author , Arie ParnhamArie Parnham More articles by this author , and Christian D. FankhauserChristian D. Fankhauser More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003298.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Early detection and treatment of local recurrence after penile sparing surgery is crucial as 10% of men with local recurrence develops metastatic disease. An important risk factor for local recurrence represents a positive surgical margin as 90% of men with a positive surgical margin show remaining cancer in subsequent reresections. The risk of local recurrence in men with no penile cancer but the precancerous lesion penile intraepithelial neoplasia (PeIN) in the surgical margin is less well studied and was the aim of this analysis. METHODS: Retrospective analysis of men with distal penile cancer undergoing penile-sparing surgery. Kaplan Meier curves and Log rank test and a multivariable Cox regression adjusted for grade and stage were performed to assess the difference of local recurrence free survival in patients with PeIN positive margins and completely negative margins. RESULTS: A negative surgical margin was described in 319 men (85%), whereas PeIN in the surgical margin was found in 59 men (15%). Local recurrence was observed 30/319 (9%) of men with a negative surgical margin compared to 11/59 (19%) men with PeIN in the surgical margin. After a median follow up of 2.8 years, patients with PeIN at the margin were more likely to have local recurrence than those with negative margins (log rank p=0.03). Adjusted for T stage and grade, patients with PeIN at the surgical margin had a higher risk to develop a local recurrence than those with negative surgical margins for PeIN (HR 2.17, p=0.03). CONCLUSIONS: Men with a PeIN in the surgical margin have twice as high a chance to experience a local recurrence compared to men with a negative surgical margin without PeIN. Men with PeIN in the surgical margin should undergo closer monitoring and adjuvant treatment options should be studied. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e685 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luca Antonelli More articles by this author Esther W. C. Lee More articles by this author Allaudin Issa More articles by this author James Churchill More articles by this author Pedro Oliveira More articles by this author Maurice Lau More articles by this author Vijay Sangar More articles by this author Arie Parnham More articles by this author Christian D. Fankhauser More articles by this author Expand All Advertisement PDF downloadLoading ...