TY - JOUR
T1 - Radical penectomy, a compromise for life
T2 - Results from the PECAD study
AU - Ghahhari, Jamil
AU - Marchioni, Michele
AU - Spiess, Philippe E.
AU - Chipollini, Juan J.
AU - Nyirády, Peter
AU - Varga, Judith
AU - Ditonno, Pasquale
AU - Boccasile, Stefano
AU - Primiceri, Giulia
AU - de Nunzio, Cosimo
AU - Tema, Giorgia
AU - Tubaro, Andrea
AU - Veccia, Alessandro
AU - Antonelli, Alessandro
AU - Musi, Gennaro
AU - de Cobelli, Ottavio
AU - Conti, Andrea
AU - Puliatti, Stefano
AU - Micali, Salvatore
AU - Álvarez-Maestro, Mario
AU - Olarte, José Quesada
AU - Diogenes, Erico
AU - Lima, Marcos Venicio Alves
AU - Tracey, Andrew
AU - Guruli, Georgi
AU - Autorino, Riccardo
AU - Sountoulides, Petros
AU - Sosnowski, Roman
AU - Schips, Luigi
AU - Cindolo, Luca
N1 - Funding Information:
The data used in the study are derived from an international multicenter database (Penile Cancer Adherence study, PECAD Study database) following approval by the local ethical committees.
Publisher Copyright:
© Translational Andrology and Urology. All rights reserved.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - 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.
AB - 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.
KW - European Association of Urology guidelines (EAU guidelines)
KW - Lymphadenectomy
KW - Organ sparing surgery (OSS)
KW - Penile amputation
KW - Penile cancer (PC)
KW - Radical penectomy
KW - Survival
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UR - http://www.scopus.com/inward/citedby.url?scp=85090098910&partnerID=8YFLogxK
U2 - 10.21037/tau.2020.04.04
DO - 10.21037/tau.2020.04.04
M3 - Article
AN - SCOPUS:85090098910
VL - 9
SP - 1306
EP - 1313
JO - Translational Andrology and Urology
JF - Translational Andrology and Urology
SN - 2223-4683
IS - 3
ER -