Penile cancer in Maranh\xe3o, Northeast Brazil: the highest incidence globally?

Ronald Wagner Pereira Coelho,Janise Silva Moreno,Laisson De Moura Feitoza,Gyl Eanes Barros Silva,Joyce Santos Larges,Leudivan Ribeiro Nogueira,Antônio Augusto Moura Da Silva,Jaqueline Diniz Pinho,Dimitrius Vidal E Oliveira Garbis,Leandra Naira Zambelli Ramalho,José Ribamar Rodrigues Calixto,Athiene Maniva Teixeira Do Nascimento

doi:10.1186/s12894-018-0365-0

Abstract

BackgroundThe objectives of this study were to determine the minimum incidence of penile cancer in the poorest Brazilian state, and to describe the epidemiologic and clinical characteristics of patients diagnosed with the disease.MethodsA retrospective study of 392 patients diagnosed with penile cancer in the three most important referral center in the state was conducted during 2004–2014.ResultsThe age-standardized incidence was 6.15 per 100,000 and the crude annual incidence was 1.18 per 100,000. More than half (61.1%) of the tumors were histological grades 2 and 3, and 66.4% of tumors were classified as at least stage T2. The average age of patients was 58.6 ± 15.7 years (range, 18 to 103 years), with 20.8% of patients ≤40 years of age at diagnosis. The vast majority underwent penectomy (93%). Only 41.8% underwent lymphadenectomy, 58 patients (14.8%) received chemotherapy, and 54 patients (13.8%) received radiotherapy. Stage 3/4 and vascular invasion were statically significant at disease-free survival analysis.ConclusionThe state of Maranhão has the highest incidence of penile cancer in Brazil and globally. Tumors are locally advanced and at the time of diagnosis, and there is a high frequency among young individuals. Patients have a low socioeconomic status, making it difficult to complete treatment and receive appropriate follow-up.

Highlights

The objectives of this study were to determine the minimum incidence of penile cancer in the poorest Brazilian state, and to describe the epidemiologic and clinical characteristics of patients diagnosed with the disease
The studied sample was of composed of 286 patients newly diagnosed with penile cancer from January 2004 to December 2014 at the Cancer Hospital Aldenora Bello (HCAB)
From 2004 to 2014, 392 patients were diagnosed with penile cancer, resulting in an average of 36 cases per year

Summary

Introduction

The objectives of this study were to determine the minimum incidence of penile cancer in the poorest Brazilian state, and to describe the epidemiologic and clinical characteristics of patients diagnosed with the disease. Penile cancer is a rare neoplasm in developed countries. The incidence in developing countries in Asia, Africa, and Latin America is high, accounting for up to 10% of malignant neoplasms in men [1,2,3]. According to the Ministry of Health, during the period 1992–2007, 6716 penectomies were performed in Brazil, out of which 419 (6.2%) in the state of Maranhão. These data, albeit alarming, are underestimated and insufficient for understanding the reality of penile cancer in Maranhão. The objectives of this study were to estimate the minimum incidence of penile

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Conclusion