PD53-08 INVERTED URETHRAL FLAP RECONSTRUCTION AFTER PARTIAL PENECTOMY: LONG-TERM ONCOLOGICAL AND FUNCTIONAL OUTCOMES

Abstract

You have accessJournal of UrologyPenile & Testicular Cancer: Penile & Testicular Cancer II (PD53)1 Sep 2021PD53-08 INVERTED URETHRAL FLAP RECONSTRUCTION AFTER PARTIAL PENECTOMY: LONG-TERM ONCOLOGICAL AND FUNCTIONAL OUTCOMES Julian Chavarriaga, Luis Becerra, Diego Camacho, Fabian Godoy, Jorge Forero, Marino Cabrera, Byron Lopez-De-Mesa, Angie Ramirez, Daniel Suso-Palau, and Rodolfo Varela Julian ChavarriagaJulian Chavarriaga More articles by this author , Luis BecerraLuis Becerra More articles by this author , Diego CamachoDiego Camacho More articles by this author , Fabian GodoyFabian Godoy More articles by this author , Jorge ForeroJorge Forero More articles by this author , Marino CabreraMarino Cabrera More articles by this author , Byron Lopez-De-MesaByron Lopez-De-Mesa More articles by this author , Angie RamirezAngie Ramirez More articles by this author , Daniel Suso-PalauDaniel Suso-Palau More articles by this author , and Rodolfo VarelaRodolfo Varela More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002080.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Penile aesthetics after partial penectomy (PP) for penile cancer (PC), significantly affects patient’s health related quality of life (HRQoL), self-esteem and sexual function. Satisfactory reconstruction has become a major milestone in the treatment of this patients. In this article we aimed to describe long-term oncological outcomes, and report HRQoL, lower urinary tract symptoms (LUTS) and erectile function in patients treated with PP and Inverted urethral flap (IUF) reconstruction at a high-volume center. METHODS: Clinical charts of all patients that underwent partial penectomy (PP) and reconstruction with an inverted urethral flap (IUF) between 2007 and 2019 were reviewed after IRB approval. The primary end points were recurrence free survival (RFS), overall survival (OS) and progression-free survival (PFS), which were graphically represented by Kaplan-Meier estimates. The key secondary end points were Health related quality of life (HRQoL), erectile function, LUTS, and surgical-related complications. We used a cross-sectional design to evaluate these outcomes with the EQ-5D-3L, IIEF-5 and ICIQ-MLUTS validated questionnaires. RESULTS: Between May 2007 and December 2019, 74 patients with PC underwent PP and IUF reconstruction. Median age was 62 years (IQR 52-76), median follow up 72 months (IQR 38-121). Twenty-nine patients (39.2%) underwent inguinal lymph node dissection (ILND), 62 (83.8%) underwent dynamic sentinel lymph node biopsy (DSLNB). At the time of data analysis, 6 patients (8.1%) have had local recurrence, 12% initially staged as cN0 had nodal progression, and 9 developed metastases. At the time of data analysis, 10 patients (13.5%) had died, 8 due to PC. Kaplan-Meier estimates of OS, RFS and PFS showed a 6-year OS of 86.5%, 6-year RFS of 90.5% and a 6-year PFS of 85.1%. Regarding functional outcomes, we found a mean global health score of 84.6% SD 10.4 at the EQ-5D-3L-VAS. Mean Voiding score (VS) of the ICIQ-MLUTS was 1.7 SD 3.2 and mean impact on quality of life (BS) was 6.5 SD 6.6. Erectile dysfunction was assessed with the SHIM/IIEF-5, the mean score was 17.3 SD 7. An exploratory analysis was conducted, stratifying patients according to initial cN stage. Six-year OS for cN+ patients was 63.7% vs. 96.2% in cN0, and 6-year PFS was 50% in cN+, and 76% in cN0. CONCLUSIONS: To the best of our knowledge, we report the largest cohort in the literature of PP with IUF reconstruction. These results are important since early-stage PC is the most common stage at diagnosis. Offering this technique to carefully selected patients, can avoid disfiguring surgery, while preserving a patient´s HRQoL. Recurrence rates are higher than in TP, but they can generally be effectively salvaged in most patients, and survival and progression of the disease seem to be directly related to nodal status at the time of initial treatment. Source of Funding: Authors have no funding sources to report © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e919-e919 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Julian Chavarriaga More articles by this author Luis Becerra More articles by this author Diego Camacho More articles by this author Fabian Godoy More articles by this author Jorge Forero More articles by this author Marino Cabrera More articles by this author Byron Lopez-De-Mesa More articles by this author Angie Ramirez More articles by this author Daniel Suso-Palau More articles by this author Rodolfo Varela More articles by this author Expand All Advertisement Loading ...